Adipose-derived stem/stromal cells (ASCs) as a potential treatment for chronic wounds in clinical conditions

Abstract

Treatment of hard-to-heal, chronic wounds, particularly in palliative patients or in intensive care units, constitutes a significant issue. Due to the constant development in this field of medicine and numerous scientific reports, it is possible to use a variety of techniques and dressings in the difficult-to-heal wound treatment. However, a promising strategy and an alternative to conventional dressings may be the transplantation of cell-coated bio-scaffolds into the wound. In addition to keratinocytes or fibroblasts transplants, which show promising healing effects during scarring, an interesting solution seems to be the use of multipotent mesenchymal stem/stromal cells, for instance, those derived from the adipose tissue (ASCs). Stem/stromal cell therapy presents a variety of benefits e.g., the isolation itself is simple, has minimal side effects, and any adipose tissue in an adult body may be the source of the cells. The presence of stem/stromal cells at the site of skin damage not only stimulates their proliferation or migration, but also their differentiation into other necessary cell types and continuous recovery at the site of a chronic wound. ASCs are also characterized by high paracrine activity, they are capable of secreting many growth factors, cytokines, and extracellular vehicles (EVs) to the external wound environment. They may also stimulate cell-to-cell interactions and improve the survival of resident cells. The multitude of mechanisms which can promote stem/stromal cells at the site of a chronic wound may potentially lead to more effective repair and regeneration processes and ultimately faster recovery. However, cell therapy requires detailed further research, in particular clinical trials, in order to assess the practicality and cost-effectiveness of this application in clinical environments and in hospital wards.