The skin forms the outer barrier of the body and also functions as a regulator of body temperature. The process of wound healing involves 3 stages: inflammation, proliferation and remodelling that are controlled by many growth factors and cytokines. A loss of regulation can cause over-healing and the formation of scars that not only cause discomfort to a patient but also involve spending for treatment. The usual care of wounds involves the use of “dressings” that prevent infection and facilitate to heal scars. Yet the success of current approaches is far from ideal and involves a lot of costs (Dehkordi et al, 2019; Jones et al, 2019).
This brings regenerative therapies in treating wounds. The application of stem cells to skin injuries becomes favourable as the skin is exposed compared to other “internal” organs. A suitable approach to deliver stem cells has been the “seed and soil” approach: the stem cells as the “seed” and a supportive framework as the “soil”-the latter allows for the efficient functioning of stem cells in the damaged tissue.
A few examples of using various stem cells to heal scars or treating wounds are given below:
Mesenchymal stem cells (MSCs) have been shown to be involved in the 3 phases of wound healing. They secrete growth factors that support the process of re-epithelialization and angiogenesis to cause wound closure and healing. Another key aspect of MSCs is immune modulation.
Early work in 2007 in Regenerative medicine by researchers Lataillade and team showed that bone marrow-derived mesenchymal stem cells augmented to heal scars of a severe radiation burn of a 27-year-old victim. A combination of numerical dosimetry-guided surgery and cellular therapy showed no-repeat incidences of inflammation in the patient at 11 months post-treatment.
A combined approach of mesenchymal stem cells from the bone marrow stem cells, platelets, fibrin glue, and collagen in 8 patients with non-healing diabetic ulcers caused healing in 3 patients and evident reduction of the wound in the remaining five patients in a report published by Ravari and colleagues in Cytotherapy (2011).
A 2017-published article in the Tropical Journal of Pharmaceutical Research reported the use of MSCs from the bone marrow of the femur and tibia in wounds induced in mice. Wound healing was accelerated by the use of stem cell therapy as seen by the recovery of tensile strength.
Adipose-derived stem cells have been found to accelerate wound healing release the factor: VEGF to trigger the formation of new blood vessels at wounds. The proliferation of human dermal fibroblasts and the synthesis of collagen involved in wound healing were caused by adipose stem cells showing the potential of these stem cells in healing (Dehkordi et al, 2019).
Similarly, the treatment of diabetic ulcers with human umbilical cord derived mesenchymal stem cells increased the levels of glycosaminoglycans and collagen associated with wound healing (Jung et al, 2018).
The use of stem cells shows promise in the treatment of wounds and to heal scars to help realize the dream of getting perfect skin post-wounds.
Jones, R.E., Foster, D.S., Hu, M.S. and Longaker, M.T. (2019) Wound healing and fibrosis: current stem cell therapies. Transfusion, 59: 884-892. doi:10.1111/trf.14836.
Nourian Dehkordi, A., Mirahmadi Babaheydari, F., Chehelgerdi, M. et al. Skin tissue engineering: wound healing based on stem-cell-based therapeutic strategies. Stem Cell Res Ther 10, 111 (2019). https://doi.org/10.1186/s13287-019-1212-2
D-j L, Shen C-a, T-j S, Zhang L, Deng H-p, Chai K. Mesenchymal stem cells promote incision wound repair in a mouse model. Tropical Journal of Pharmaceutical Research 2017;16:1317–23.
Lataillade JJ, Doucet C, Bey E, Carsin H, Huet C, Clairand I, Bottollier-Depois JF, Chapel A, Ernou I, Gourven M, et al. New approach to radiation burn treatment by dosimetry-guided surgery combined with autologous mesenchymal stem cell therapy. Regenerative medicine 2007;2:785–94.
Ravari H, Hamidi-Almadari D, Salimifar M, Bonakdaran S, Parizadeh MR, Koliakos G. Treatment of non-healing wounds with autologous bone marrow cells, platelets, fibrin glue and collagen matrix. Cytotherapy. 2011;13:705–11.
Jung JA, Yoon YD, Lee HW, Kang SR, Han SK. Comparison of human umbilical cord blood-derived mesenchymal stem cells with healthy fibroblasts on wound-healing activity of diabetic fibroblasts. International Wound Journal 2018;15(1):133–9.