Ahmad Qadeer, Mehdi Shumaila, Mehmood Malik Hassan, Asif Muhammad Talha, Ali Muhammad Mohsin
Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, 38000, Pakistan.
Department of Pharmaceutical Sciences, Government College University, Lahore, 54000, Pakistan.
Inflammopharmacology. 2025 Sep 4. doi: 10.1007/s10787-025-01924-6.
Chronic wounds represent significant challenges to the healthcare system. Their incidence increases with increase in age, especially in individuals suffering from chronic disorders like diabetes. The process of wound healing consists of a series of coordinated biological events triggered by tissue damage, ultimately leading to the repair and restoration of damaged tissues. Various pharmacological and non-pharmacological interventions are employed for the management of chronic wounds. The clinical application of traditional therapeutic modalities for managing chronic wounds is limited due to the associated adverse effects, like antimicrobial resistance, pressure lesions, ear and nose barotrauma, and convulsions. Recent advancements in stem cell therapy hold promise for the management of chronic wounds. These are the undifferentiated cells of the human body with the capability of self-renewal. These cells migrate to the wounded site and transform into the required type of cell to repair the tissues. The use of autologous stem cells decreases the risk of immune rejection and infections. These cells do not carry the risk of transmitting contagious diseases from the donor. Various types of stem cells have been investigated in the management of chronic wounds using diverse modes. These cells can be administered topically on the wounded site or through various matrices, such as hydrogels, scaffolds, extracellular matrix derivatives, and dermal substitutes. These cells promote the healing process by acting directly or indirectly on various pathogenic targets in chronic wounds. This review aims to explore the potential of stem cells in chronic wound management, including diabetic foot ulcers, burn ulcers, pressure ulcers, inherited epidermolysis bullosa, and venous leg ulcers. This review also highlights the molecular and cellular pathways involved in wound healing discussed in this review. Moreover, various pre-clinical and clinical studies exploring the use of stem cells in chronic wounds are also reviewed. In sum, the current review weighs the limitations associated with traditional therapies and the merits of the potential application of stem cells in chronic wound management.
慢性伤口对医疗保健系统构成了重大挑战。其发病率随着年龄的增长而增加，尤其是在患有糖尿病等慢性疾病的个体中。伤口愈合过程包括一系列由组织损伤引发的协调生物事件，最终导致受损组织的修复和恢复。各种药物和非药物干预措施被用于慢性伤口的管理。由于传统治疗方式存在诸如抗菌耐药性、压力性损伤、耳和鼻气压伤以及惊厥等相关不良反应，其在慢性伤口管理中的临床应用受到限制。干细胞治疗的最新进展为慢性伤口的管理带来了希望。这些是人体具有自我更新能力的未分化细胞。这些细胞迁移到受伤部位并转化为所需类型的细胞以修复组织。使用自体干细胞可降低免疫排斥和感染的风险。这些细胞不存在从供体传播传染病的风险。已经使用多种方式对各种类型的干细胞在慢性伤口管理中的应用进行了研究。这些细胞可以局部应用于受伤部位或通过各种基质，如水凝胶、支架、细胞外基质衍生物和皮肤替代物给药。这些细胞通过直接或间接作用于慢性伤口中的各种致病靶点来促进愈合过程。本综述旨在探讨干细胞在慢性伤口管理中的潜力，包括糖尿病足溃疡、烧伤溃疡、压疮、遗传性大疱性表皮松解症和下肢静脉溃疡。本综述还强调了本综述中讨论的伤口愈合所涉及的分子和细胞途径。此外，还综述了探索干细胞在慢性伤口中应用的各种临床前和临床研究。总之，当前的综述权衡了传统疗法的局限性以及干细胞在慢性伤口管理中潜在应用的优点。
