Use of Stem Cells in Wound Healing

Applications of Electrospun Drug-Eluting Nanofibers in Wound Healing: Current and Future Perspectives

Wounds are a consequence of disruption in the structure, integrity, or function of the skin or tissue. Once a wound is formed following mechanical or chemical damage, the process of wound healing is initiated, which involves a series of chemical signaling and cellular mechanisms that lead to regeneration and/or repair. Disruption in the healing process may result in complications; therefore, interventions to accelerate wound healing are essential. In addition to mechanical support provided by sutures and traditional wound dressings, therapeutic agents play a major role in accelerating wound healing. The medicines known to improve the rate and extent of wound healing include antibacterial, anti-inflammatory, and proliferation enhancing agents. Nonetheless, the development of these agents into eluting nanofibers presents the possibility of fabricating wound dressings and sutures that provide mechanical support with the added advantage of local delivery of therapeutic agents to the site of injury. Herein, the process of wound healing, complications of wound healing, and current practices in wound healing acceleration are highlighted. Furthermore, the potential role of drug-eluting nanofibers in wound management is discussed, and lastly, the economic implications of wounds as well as future perspectives in applying fiber electrospinning in the design of wound dressings and sutures are considered and reported.

The effect of stromal vascular fraction and Platelet-Rich Plasma combination on basic Fibroblast Growth Factor serum level during anal trauma healing in a Wistar rat model

Introduction

Stromal Vascular Fraction (SVF) and Platelet-Rich Plasma (PRP) application play important roles in the healing process by increasing basic Fibroblast Growth Factor (bFGF) secretion. This research assesses the effect of combined SVF and PRP local injection on bFGF levels, using an anal trauma model in Wistar rats.

Method

Twenty-eight adult Wistar rats were divided into three groups. Groups A and B underwent modified surgical anal trauma and repair; Group A was treated with the SVF and PRP combination local injection, while Group B was treated with only normal saline. Subsequently, we examined bFGF levels in Groups A and B on days 1, 7, and 14. Group C consisted of healthy controls sacrificed on day 0 to obtain baseline data on bFGF levels.

Results

The bFGF levels were higher in Group A than in Group B on every experimental day. The Repeated Measures test shows a significant increase in bFGF levels on day 1 (p = 0.000), day 7 (p = 0.000), and day 14 (p = 0.000). This test also indicates that the local injection combination of SVF and PRP increased bFGF levels by 96.2% compared to the placebo group.

Conclusion

The combination of SVF and PRP can increase bFGF levels during anal trauma healing in the Wistar rat model. Basic FGF is an important factor throughout the anal trauma healing process.

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The combination of SVFs and PRP is effective to increase the concentration of bFGF.

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Administration of SVFS + PRP by injection was better at increasing the expression of bFGF than by placebo.

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The combination of SVFs and PRP increases the level of bFGF in the healing process of anal trauma.

Porous polysaccharide scaffolds: Proof of concept study on wound healing and stem cell differentiation

The combination of desirable polymer properties and methods for synthesis, utilizing materials with various architectures, could be adopted for diverse clinical applications such as wound healing as well as stem cell differentiation. Natural polymers, particularly polysaccharides, are biocompatible and are reported to have structural similarities with extracellular matrix components. In this scenario, the present study fabricated a porous scaffold using a polysaccharide, galactoxyloglucan, isolated from Tamarind seed kernel, and studied its applications in stem cell attachment and wound healing. In-growth of human mesenchymal stem cells (hMSCs) presented a rounded morphology with increased proliferation. Scaffolds were surface-functionalized with silver nanoparticles to increase the antibacterial activity and the wound healing potential evaluated in preclinical mouse models. The current study provides an insight into how stem cells attach and grow in a naturally derived low-cost polysaccharide scaffold with antibacterial, biocompatible, and biodegradable properties.

Role of stem cell therapies in treating chronic wounds: A systematic review

BACKGROUND

The impairment of cutaneous wound healing results in chronic, non-healing wounds that are caused by altered wound environment oxygenation, tissue injury, and permissive microbial growth. Current modalities for the treatment of these wounds inadequately address the complex changes involved in chronic wound pathogenesis. Consequently, stem cell therapies have emerged as a potential therapeutic modality to promote cutaneous regeneration through trophic and paracrine activity.

AIM

To investigate current literature regarding use of stem cell therapies for the clinical treatment of chronic, non-healing wounds.

METHODS

PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus were queried with combinations of the search terms “mesenchymal stem cells,” “adult stem cells,” “embryonic stem cells,” “erythroid precursor cells,” “stem cell therapies,” and “chronic wounds” in order to find relevant articles published between the years of 2000 and 2019 to review a 20-year experience. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts (reviews, case reports/series, retrospective/prospective studies, and clinical trials) were evaluated by the authors for their depiction of clinical stem cell therapy use. Data were extracted from the articles using a standardized collection tool.

RESULTS

A total of 43 articles describing the use of stem cell therapies for the treatment of chronic wounds were included in this review. While stem cell therapies have been explored in in vitro and in vivo applications in the past, recent efforts are geared towards assessing their clinical role. A review of the literature revealed that adipose-derived stem cells, bone marrow-derived stem cells, bone marrow-derived mononuclear cells, epidermally-derived mesenchymal stem cells, fibroblast stem cells, keratinocyte stem cells, placental mesenchymal stem cells, and umbilical cord mesenchymal stem cells have all been employed in the treatment of chronic wounds of various etiologies. Most recently, embryonic stem cells have emerged as a novel stem cell therapy with the capacity for multifaceted germ cell layer differentiation. With the capacity for self-renewal and differentiation, stem cells can enrich existing cell populations in chronic wounds in order to overcome barriers impeding the progression of wound healing. Further, stem cell therapies can be utilized to augment cell engraftment, signaling and activity, and resultant patient outcomes.

CONCLUSION

Assessing observed clinical outcomes, potential for stem cell use, and relevant therapeutic challenges allows wound care stakeholders to make informed decisions regarding optimal treatment approaches for their patients’ chronic wounds.