Abstract

BackgroundPatients with severe burn injury (over 20% of the total body surface area) experience profound hypermetabolism which significantly prolongs wound healing. Adipose-derived stem cells (ASCs) have been proposed as an attractive solution for treating burn wounds, including the potential for autologous ASC expansion. While subcutaneous adipocytes display an altered metabolic profile post-burn, it is not known if this is the case with the stem cells associated with the adipose tissue.MethodsASCs were isolated from discarded burn skin of severely injured human subjects (BH, n = 6) and unburned subcutaneous adipose tissue of patients undergoing elective abdominoplasty (UH, n = 6) and were analyzed at passages 2, 4, and 6. Flow cytometry was used to quantify ASC cell surface markers CD90, CD105, and CD73. Mitochondrial abundance and reactive oxygen species (ROS) production were determined with MitoTracker Green and MitoSOX Red, respectively, while JC-10 Mitochondrial Membrane Potential Assays were also performed. Mitochondrial respiration and glycolysis were analyzed with a high-resolution respirometer (Seahorse XFe24 Analyzer).ResultsThere was no difference in age between BH and UH (34 ± 6 and 41 ± 4 years, respectively, P = 0.49). While passage 2 ASCs had lower ASC marker expression than subsequent passages, there were no significant differences in the expression between BH and UH ASCs. Similarly, no differences in mitochondrial abundance or membrane potential were found amongst passages or groups. Two-way ANOVA showed a significant effect (P < 0.01) of passaging on mitochondrial ROS production, with increased ROS in BH ASCs at later passages. Oxidative phosphorylation capacities (leak and maximal respiration) increased significantly in BH ASCs (P = 0.035) but not UH ASCs. On the contrary, basal glycolysis significantly decreased in BH ASCs (P = 0.011) with subsequent passaging, but not UH ASCs.ConclusionsIn conclusion, ASCs from burned individuals become increasingly oxidative and less glycolytic upon passaging when compared to ASCs from unburned patients. This increase in oxidative capacities was associated with ROS production in later passages. While the autologous expansion of ASCs holds great promise for treating burned patients with limited donor sites, the potential negative consequences of using them require further investigation.

Highlights

  • IntroductionPatients with severe burn injury (over 20% of the total body surface area) experience profound hypermetabolism which significantly prolongs wound healing

  • Patients with severe burn injury experience profound hypermetabolism which significantly prolongs wound healing

  • While passage 2 Adipose-derived stem cells (ASCs) had lower ASC marker expression than subsequent passages, there were no significant differences in the expression between burned human (BH) and unburned human (UH) ASCs

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Summary

Introduction

Patients with severe burn injury (over 20% of the total body surface area) experience profound hypermetabolism which significantly prolongs wound healing. Even with increased survival associated with improved care of burned patients, there is often the need for multiple surgeries due to inadequate outcomes and unsuccesful wound healing This is especially the case with extensive burns where there are limited donor sites for autografting during surgery. While a recently FDAapproved strategy uses autologous cells [7], exploration of novel allogeneic therapies is an attractive solution to treat burned patients [8] To this end, adipose-derived stem cells (ASCs) are a type of mesenchymal stem cell that possess immunosuppressive activity, making their allogeneic use possible [9, 10]. Evidence to support the therapeutic potential of ASCs to improve wound healing after thermal burns were previously demonstrated in small and large animal models [17,18,19]

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