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Zomer HD, de Souza Lima VJ, Bion MC, Brito KNL, Rode M, Stimamiglio MA, Jeremias TDS, Trentin AG. Evaluation of secretomes derived from human dermal and adipose tissue mesenchymal stem/stromal cells for skin wound healing: not as effective as cells. Stem Cell Res Ther 2024; 15:15. [PMID: 38229157 PMCID: PMC10792854 DOI: 10.1186/s13287-023-03630-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Although the paracrine effects of mesenchymal stem/stromal cells (MSCs) have been recognized as crucial mediators of their regenerative effects on tissue repair, the potential of MSC secretomes as effective substitutes for cellular therapies remains underexplored. METHODS In this study, we compared MSCs from the human dermis (DSCs) and adipose tissue (ASCs) with their secretomes regarding their efficacy for skin wound healing using a translationally relevant murine model. RESULTS Proteomic analysis revealed that while there was a substantial overlap in protein composition between DSC and ASC secretomes, specific proteins associated with wound healing and angiogenesis were differentially expressed. Despite a similar angiogenic potential in vivo, DSC and ASC secretomes were found to be less effective than cells in accelerating wound closure and promoting tissue remodeling. CONCLUSIONS Overall, secretome-treated groups showed intermediary results between cells- and control-treated (empty scaffold) groups. These findings highlight that although secretomes possess therapeutic potential, their efficacy might be limited compared to cellular therapies. This study contributes to the growing understanding of MSC secretomes, emphasizes the need for further protocol optimization, and offers insights into their potential applications in regenerative medicine.
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Affiliation(s)
- Helena Debiazi Zomer
- Department of Physiological Sciences, University of Florida, Gainesville, USA.
- Department of Cell Biology, Embryology, and Genetics, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Victor Juan de Souza Lima
- Department of Cell Biology, Embryology, and Genetics, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Monique Coelho Bion
- Department of Cell Biology, Embryology, and Genetics, Federal University of Santa Catarina, Florianópolis, Brazil
- National Institute of Translational Neuroscience, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Karynne Nazare Lins Brito
- Department of Cell Biology, Embryology, and Genetics, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Michele Rode
- Department of Cell Biology, Embryology, and Genetics, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Marco Augusto Stimamiglio
- Laboratory for Stem Cells Basic Biology, Carlos Chagas Institute, FIOCRUZ/PR, Curitiba, Paraná, Brazil
| | - Talita da Silva Jeremias
- Department of Cell Biology, Embryology, and Genetics, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Andrea Gonçalves Trentin
- Department of Cell Biology, Embryology, and Genetics, Federal University of Santa Catarina, Florianópolis, Brazil
- National Institute of Science and Technology for Regenerative Medicine, Rio de Janeiro, Brazil
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Zielinska D, Fisch P, Moehrlen U, Finkielsztein S, Linder T, Zenobi-Wong M, Biedermann T, Klar AS. Combining bioengineered human skin with bioprinted cartilage for ear reconstruction. SCIENCE ADVANCES 2023; 9:eadh1890. [PMID: 37792948 PMCID: PMC10550230 DOI: 10.1126/sciadv.adh1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/01/2023] [Indexed: 10/06/2023]
Abstract
Microtia is a congenital disorder that manifests as a malformation of the external ear leading to psychosocial problems in affected children. Here, we present a tissue-engineered treatment approach based on a bioprinted autologous auricular cartilage construct (EarCartilage) combined with a bioengineered human pigmented and prevascularized dermo-epidermal skin substitute (EarSkin) tested in immunocompromised rats. We confirmed that human-engineered blood capillaries of EarSkin connected to the recipient's vasculature within 1 week, enabling rapid blood perfusion and epidermal maturation. Bioengineered EarSkin displayed a stratified epidermis containing mature keratinocytes and melanocytes. The latter resided within the basal layer of the epidermis and efficiently restored the skin color. Further, in vivo tests demonstrated favorable mechanical stability of EarCartilage along with enhanced extracellular matrix deposition. In conclusion, EarCartilage combined with EarSkin represents a novel approach for the treatment of microtia with the potential to circumvent existing limitations and improve the aesthetic outcome of microtia reconstruction.
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Affiliation(s)
- Dominika Zielinska
- Tissue Biology Research Unit, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Philipp Fisch
- Tissue Engineering and Biofabrication Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Ueli Moehrlen
- Tissue Biology Research Unit, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | | | - Thomas Linder
- Klinik für Hals-, Nasen-, Ohren- und Gesichtschirurgie, Luzerner Kantonsspital, Luzern, Switzerland
| | - Marcy Zenobi-Wong
- Tissue Engineering and Biofabrication Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Thomas Biedermann
- Tissue Biology Research Unit, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Agnes S. Klar
- Tissue Biology Research Unit, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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Moiemen N, Schiestl C, Hartmann-Fritsch F, Neuhaus K, Reichmann E, Löw A, Stenger C, Böttcher-Haberzeth S, Meuli M. First time compassionate use of laboratory engineered autologous Zurich skin in a massively burned child. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2021.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Schiestl C, Meuli M, Vojvodic M, Pontiggia L, Neuhaus D, Brotschi B, Reichmann E, Böttcher-Haberzeth S, Neuhaus K. Expanding into the future: Combining a novel dermal template with distinct variants of autologous cultured skin substitutes in massive burns. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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5
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Meuli M, Hartmann-Fritsch F, Hüging M, Marino D, Saglini M, Hynes S, Neuhaus K, Manuel E, Middelkoop E, Reichmann E, Schiestl C. A Cultured Autologous Dermo-epidermal Skin Substitute for Full-Thickness Skin Defects: A Phase I, Open, Prospective Clinical Trial in Children. Plast Reconstr Surg 2019; 144:188-198. [PMID: 31246829 DOI: 10.1097/prs.0000000000005746] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The management of deep partial-thickness and full-thickness skin defects remains a significant challenge. Particularly with massive defects, the current standard treatment, split-thickness skin grafting, is fraught with donor-site limitations and unsatisfactory long-term outcomes. A novel, autologous, bioengineered skin substitute was developed to address this problem. METHODS To determine whether this skin substitute could safely provide permanent defect coverage, a phase I clinical trial was performed at the University Children's Hospital Zurich. Ten pediatric patients with acute or elective deep partial- or full-thickness skin defects were included. Skin grafts of 49 cm were bioengineered using autologous keratinocytes and fibroblasts isolated from a patient's small skin biopsy specimen (4 cm), incorporated in a collagen hydrogel. RESULTS Graft take, epithelialization, infection, adverse events, skin quality, and histology were analyzed. Median graft take at 21 days postoperatively was 78 percent (range, 0 to 100 percent). Healed skin substitutes were stable and skin quality was nearly normal. There were four cases of hematoma leading to partial graft loss. Histology at 3 months revealed a well-stratified epidermis and a dermal compartment comparable to native skin. Mean follow-up duration was 15 months. CONCLUSIONS In the first clinical application of this novel skin substitute, safe coverage of skin defects was achieved. Safety and efficacy phase II trials comparing the novel skin substitute to split-thickness skin grafts are ongoing. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Martin Meuli
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Fabienne Hartmann-Fritsch
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Martina Hüging
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Daniela Marino
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Monia Saglini
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Sally Hynes
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Kathrin Neuhaus
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Edith Manuel
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Esther Middelkoop
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Ernst Reichmann
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
| | - Clemens Schiestl
- From the Pediatric Burn Center, Plastic and Reconstructive Surgery, Children's Skin Center, the Tissue Biology Research Unit, Department of Surgery, and the Children's Research Center, University Children's Hospital Zurich; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam Movement Sciences
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Fleischmann T, Nicholls F, Lipiski M, Arras M, Cesarovic N. Transplantation of Autologous Dermo-Epidermal Skin Substitutes in a Pig Model. Methods Mol Biol 2019; 1993:251-259. [PMID: 31148093 DOI: 10.1007/978-1-4939-9473-1_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Due to its similarity of skin anatomy and physiology, the pig appears to be a well-suited animal model for preclinical studies of skin analog transplantations. The choice of the location of the skin defect and appropriate postoperative measures are essential for the protection of the transplanted graft. This protocol describes in detail a porcine skin transplantation model including peri- and postoperative measures taken to improve and refine the study outcome.
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Affiliation(s)
- Thea Fleischmann
- Division of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland. .,Biological Central Laboratory, University of Zurich, Zurich, Switzerland.
| | - Flora Nicholls
- Biological Central Laboratory, University of Zurich, Zurich, Switzerland
| | - Miriam Lipiski
- Division of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Biological Central Laboratory, University of Zurich, Zurich, Switzerland
| | - Margarete Arras
- Division of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nikola Cesarovic
- Division of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Induction of angiogenic and inflammation-associated dermal biomarkers following acute UVB exposure on bio-engineered pigmented dermo-epidermal skin substitutes in vivo. Pediatr Surg Int 2019; 35:129-136. [PMID: 30430280 DOI: 10.1007/s00383-018-4384-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE Ultraviolet (UV) radiation adversely affects skin health at cellular and molecular levels. Hence, UV radiation can directly induce inflammatory responses in the dermis by inducing erythema, edema, inflammation, dermal fibroblasts alterations, and extracellular matrix modifications. METHODS Human keratinocytes, melanocytes, and fibroblasts were isolated from skin biopsies, cultured, and expanded in vitro. Fibroblasts were seeded into collagen type I hydrogels that were subsequently covered by keratinocytes and melanocytes. These pigmented dermo-epidermal skin substitutes (pigmDESS) were transplanted for 5 weeks onto full-thickness skin wounds on the back of immuno-incompetent rats, exposed to a single UVB dose of 250 mJ/cm2 or unexposed and excised after 1 week. The effects onto the dermis were assessed regarding cell number, cell phenotype, and cell proliferation. Local inflammation by granulocytes (HIS48) or macrophages (CD11b, iNOS) was analyzed by immunohistochemistry staining. RESULTS We observed a significantly enhanced ingrowth rate of blood capillaries, but not of lymphatic capillaries at 1 week post-irradiation. Moreover, the enhanced vascularization of pigmDESS after UVB exposure was concomitant with a high infiltration of granulocytes and monocytes/macrophages to the dermal part of grafts. In addition, a heterogeneous expression of HIF-1α and TNFα was detected at this early phase after UVB exposure. In local cellular response examination, results only show a moderate cell proliferation in the dermis. CONCLUSIONS We were able to define early markers of UVB-induced effects in the dermis of pigmDESS. Overall, a single UVB dose induces temporary acute angiogenic and immune responses during the early post-irradiation phase in vivo.
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Skin-Derived Stem Cells for Wound Treatment Using Cultured Epidermal Autografts: Clinical Applications and Challenges. Stem Cells Int 2018; 2018:4623615. [PMID: 29765411 PMCID: PMC5889868 DOI: 10.1155/2018/4623615] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 01/03/2018] [Indexed: 12/15/2022] Open
Abstract
The human skin fulfills important barrier, sensory, and immune functions-all of which contribute significantly to health and organism integrity. Widespread skin damage requires immediate treatment and coverage because massive skin loss fosters the invasion of pathogens, causes critical fluid loss, and may ultimately lead to death. Since the skin is a highly immunocompetent organ, autologous transplants are the only viable approach to permanently close a widespread skin wound. Despite the development of tissue-saving autologous transplantation techniques such as mesh and Meek grafts, treatment options for extensive skin damage remain severely limited. Yet, the skin is also a rich source of stem and progenitor cells. These cells promote wound healing under physiological conditions and are potential sources for tissue engineering approaches aiming to augment transplantable tissue by generating cultured epidermal autografts (CEAs). Here, we review autologous tissue engineering strategies as well as transplantation products based on skin-derived stem cells. We further provide an overview of clinical trial activities in the field and discuss relevant translational and clinical challenges associated with the use of these products.
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9
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Pensalfini M, Ehret AE, Stüdeli S, Marino D, Kaech A, Reichmann E, Mazza E. Factors affecting the mechanical behavior of collagen hydrogels for skin tissue engineering. J Mech Behav Biomed Mater 2017; 69:85-97. [DOI: 10.1016/j.jmbbm.2016.12.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 12/13/2022]
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Skin Tissue Engineering: Application of Adipose-Derived Stem Cells. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9747010. [PMID: 28337463 PMCID: PMC5350314 DOI: 10.1155/2017/9747010] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/23/2016] [Accepted: 10/30/2016] [Indexed: 02/06/2023]
Abstract
Perception of the adipose tissue has changed dramatically over the last few decades. Identification of adipose-derived stem cells (ASCs) ultimately transformed paradigm of this tissue from a passive energy depot into a promising stem cell source with properties of self-renewal and multipotential differentiation. As compared to bone marrow-derived stem cells (BMSCs), ASCs are more easily accessible and their isolation yields higher amount of stem cells. Therefore, the ASCs are of high interest for stem cell-based therapies and skin tissue engineering. Currently, freshly isolated stromal vascular fraction (SVF), which may be used directly without any expansion, was also assessed to be highly effective in treating skin radiation injuries, burns, or nonhealing wounds such as diabetic ulcers. In this paper, we review the characteristics of SVF and ASCs and the efficacy of their treatment for skin injuries and disorders.
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Martin YH, Jubin K, Smalley S, Wong JPF, Brown RA, Metcalfe AD. A novel system for expansion and delivery of human keratinocytes for the treatment of severe cutaneous injuries using microcarriers and compressed collagen. J Tissue Eng Regen Med 2017; 11:3124-3133. [PMID: 28052577 DOI: 10.1002/term.2220] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 04/06/2016] [Accepted: 04/19/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Y. H. Martin
- Blond McIndoe Research Foundation; Queen Victoria Hospital; East Grinstead West Sussex UK
- Brighton Centre for Regenerative Medicine; University of Brighton; Brighton East Sussex UK
| | - K. Jubin
- Blond McIndoe Research Foundation; Queen Victoria Hospital; East Grinstead West Sussex UK
| | - S. Smalley
- Blond McIndoe Research Foundation; Queen Victoria Hospital; East Grinstead West Sussex UK
| | - J. P. F. Wong
- UCL Tissue Repair and Engineering Centre; University College London; London UK
| | - R. A. Brown
- UCL Tissue Repair and Engineering Centre; University College London; London UK
| | - A. D. Metcalfe
- Blond McIndoe Research Foundation; Queen Victoria Hospital; East Grinstead West Sussex UK
- Brighton Centre for Regenerative Medicine; University of Brighton; Brighton East Sussex UK
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The Effect of Wound Dressings on a Bio-Engineered Human Dermo-Epidermal Skin Substitute in a Rat Model. J Burn Care Res 2017; 38:354-364. [DOI: 10.1097/bcr.0000000000000530] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Hartmann-Fritsch F, Marino D, Reichmann E. About ATMPs, SOPs and GMP: The Hurdles to Produce Novel Skin Grafts for Clinical Use. Transfus Med Hemother 2016; 43:344-352. [PMID: 27781022 DOI: 10.1159/000447645] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/10/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The treatment of severe full-thickness skin defects represents a significant and common clinical problem worldwide. A bio-engineered autologous skin substitute would significantly reduce the problems observed with today's gold standard. METHODS Within 15 years of research, the Tissue Biology Research Unit of the University Children's Hospital Zurich has developed autologous tissue-engineered skin grafts based on collagen type I hydrogels. Those products are considered as advanced therapy medicinal products (ATMPs) and are routinely produced for clinical trials in a clean room facility following the guidelines for good manufacturing practice (GMP). This article focuses on hurdles observed for the translation of ATMPs from research into the GMP environment and clinical application. RESULTS AND CONCLUSION Personalized medicine in the field of rare diseases has great potential. However, ATMPs are mainly developed and promoted by academia, hospitals, and small companies, which face many obstacles such as high financial burdens.
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Affiliation(s)
- Fabienne Hartmann-Fritsch
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Daniela Marino
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Ernst Reichmann
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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Böttcher-Haberzeth S, Biedermann T, Klar AS, Pontiggia L, Rac J, Nadal D, Schiestl C, Reichmann E, Meuli M. Tissue engineering of skin: human tonsil-derived mesenchymal cells can function as dermal fibroblasts. Pediatr Surg Int 2014; 30:213-22. [PMID: 24363059 DOI: 10.1007/s00383-013-3454-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE It is unclear whether dermal fibroblasts are indispensable key players for tissue engineering of dermo-epidermal skin analogs. In this experimental study, we wanted to test the hypothesis that tonsil-derived mesenchymal cells can assume the role of dermal fibroblasts when culturing pigmented skin analogs for transplantation. METHODS Mesenchymal cells from excised tonsils and keratinocytes, melanocytes, and fibroblasts from skin biopsies were isolated, cultured, and expanded. Melanocytes and keratinocytes were seeded in a ratio of 1:5 onto collagen gels previously populated either with tonsil-derived mesenchymal cells or with autologous dermal fibroblasts. These laboratory engineered skin analogs were then transplanted onto full-thickness wounds of immuno-incompetent rats and analyzed after 3 weeks with regard to macroscopic and microscopic epidermal characteristics. RESULTS The skin analogs containing tonsil-derived mesenchymal cells showed the same macroscopic appearance as the ones containing dermal fibroblasts. Histologically, features of epidermal stratification, pigmentation, and cornification were identical to those of the controls assembled with autologous dermal fibroblasts. Transmission electron microscopy confirmed these findings. CONCLUSION These data suggest that human tonsil-derived mesenchymal cells can assume dermal fibroblast functions, indicating that possibly various types of mesenchymal cells can successfully be employed for "skingineering" purposes. This aspect may have clinical implications when sources for dermal fibroblasts are scarce.
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15
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Marino D, Luginbuhl J, Scola S, Meuli M, Reichmann E. Bioengineering Dermo-Epidermal Skin Grafts with Blood and Lymphatic Capillaries. Sci Transl Med 2014; 6:221ra14. [DOI: 10.1126/scitranslmed.3006894] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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"Take" of a polymer-based autologous cultured composite "skin" on an integrated temporizing dermal matrix: proof of concept. J Burn Care Res 2013; 34:151-60. [PMID: 23292583 DOI: 10.1097/bcr.0b013e31828089f9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aimed to investigate the ability of an autologous cultured composite skin (CCS) to close similar biodegradable temporizing matrix (BTM)-integrated wounds, and its effectiveness in healing fresh full-thickness wounds after the failure of cultured epithelial autograft in its two forms (sheets and suspensions) to epithelialize over an integrated polymer BTM. Using a porcine model, autologous split-skin grafts were harvested three of four dorsal 8 × 8 cm treatment sites. These three sites were subsequently converted to full-thickness wounds and BTMs were implanted. The grafts were used to produce autologous CCSs for each pig. These consisted of a 1 mm thick biodegradable polymer foam scaffold into which fibroblasts and keratinocytes harvested from the grafts were cocultured. At Day 28, on each animal, the autologous CCSs were applied to two of the integrated BTMs, an autologous split-skin graft was applied to the third integrated BTM, and one CCS was applied immediately into a fresh, "naked" (no BTM applied) wound. The CCSs were capable of generating a bilayer repair over the naked wound's fat base and BTM-integrated wounds, which consisted of dermal elements and a keratinized stratified squamous epidermis anchored with a basement membrane by day 7. The CCSs behaved in different ways: either as a delivery vehicle allowing similar development of a bilayer repair while the polymer foam was shed from the wound, or generating a bilayer repair with the foam scaffold being retained (composite "take"). These results conclude our porcine program and provide proof of concept that the integrated BTM can be closed with an autologous CCS. Once fully optimized, this may provide robust repair without resorting to the split-skin graft, important in those cases where unburned donor site is unavailable.
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Böttcher-Haberzeth S, Klar AS, Biedermann T, Schiestl C, Meuli-Simmen C, Reichmann E, Meuli M. "Trooping the color": restoring the original donor skin color by addition of melanocytes to bioengineered skin analogs. Pediatr Surg Int 2013. [PMID: 23196807 DOI: 10.1007/s00383-012-3217-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE Autologous skin substitutes to cover large skin defects are used since several years. Melanocytes, although essential for solar protection and pigmentation of skin, are not yet systematically added to such substitutes. In this experimental study, we reconstructed melanocyte-containing dermo-epidermal skin substitutes from donor skins of different skin pigmentation types and studied them in an animal model. Features pertinent to skin color were analyzed and compared in both skin substitutes and original donor skin. METHODS Keratinocytes, melanocytes, and fibroblast were isolated, cultured, and expanded from skin biopsies of light- and dark-pigmented patients. For each donor, melanocytes and keratinocytes were seeded in different ratios (1:1, 1:5, 1:10) onto collagen gels previously populated with autologous fibroblasts. Skin substitutes were then transplanted onto full-thickness wounds of immuno-incompetent rats. After 8 weeks, macroscopic and microscopic analyses were conducted with regard to skin color and architecture. RESULTS Chromameter evaluation revealed that skin color of reconstructed light- and dark-pigmented skin was very similar to donor skin, independent of which melanocyte/keratinocyte ratio was added. Histological analyses of the skin analogs confirmed these findings. CONCLUSION These data suggest that adding autologous melanocytes to bioengineered dermo-epidermal skin analogs can sustainably restore the patients' native skin color.
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Hartmann-Fritsch F, Biedermann T, Braziulis E, Luginbühl J, Pontiggia L, Böttcher-Haberzeth S, van Kuppevelt TH, Faraj KA, Schiestl C, Meuli M, Reichmann E. Collagen hydrogels strengthened by biodegradable meshes are a basis for dermo-epidermal skin grafts intended to reconstitute human skin in a one-step surgical intervention. J Tissue Eng Regen Med 2012; 10:81-91. [PMID: 23229842 DOI: 10.1002/term.1665] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 09/28/2012] [Accepted: 11/05/2012] [Indexed: 11/10/2022]
Abstract
Extensive full-thickness skin loss, associated with deep burns or other traumata, represents a major clinical problem that is far from being solved. A promising approach to treat large skin defects is the use of tissue-engineered full-thickness skin analogues with nearly normal anatomy and function. In addition to excellent biological properties, such skin substitutes should exhibit optimal structural and mechanical features. This study aimed to test novel dermo-epidermal skin substitutes based on collagen type I hydrogels, physically strengthened by two types of polymeric net-like meshes. One mesh has already been used in clinical trials for treating inguinal hernia; the second one is new but consists of a FDA-approved polymer. Both meshes were integrated into collagen type I hydrogels and dermo-epidermal skin substitutes were generated. Skin substitutes were transplanted onto immuno-incompetent rats and analyzed after distinct time periods. The skin substitutes homogeneously developed into a well-stratified epidermis over the entire surface of the grafts. The epidermis deposited a continuous basement membrane and dermo-epidermal junction, displayed a well-defined basal cell layer, about 10 suprabasal strata and a stratum corneum. Additionally, the dermal component of the grafts was well vascularized.
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Affiliation(s)
- Fabienne Hartmann-Fritsch
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Switzerland
| | - Thomas Biedermann
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Switzerland
| | - Erik Braziulis
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Switzerland
| | - Joachim Luginbühl
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Switzerland
| | - Luca Pontiggia
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Switzerland
| | - Sophie Böttcher-Haberzeth
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Switzerland.,Department of Surgery, Paediatric Burn Centre, Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Switzerland
| | - Toin H van Kuppevelt
- Department of Matrix Biochemistry, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Kaeuis A Faraj
- Department of Matrix Biochemistry, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Clemens Schiestl
- Department of Surgery, Paediatric Burn Centre, Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Switzerland
| | - Martin Meuli
- Department of Surgery, Paediatric Burn Centre, Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Switzerland
| | - Ernst Reichmann
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Switzerland.
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