Abstract
Skin disease may be related with immunological disorders, external aggressions, or genetic conditions. Injuries or cutaneous diseases such as wounds, burns, psoriasis, and scleroderma among others are common pathologies in dermatology, and in some cases, conventional treatments are ineffective. In recent years, advanced therapies using human mesenchymal stem cells (hMSCs) from different sources has emerged as a promising strategy for the treatment of many pathologies. Due to their properties; regenerative, immunomodulatory and differentiation capacities, they could be applied for the treatment of cutaneous diseases. In this review, a total of thirteen types of hMSCs used as advanced therapy have been analyzed, considering the last 5 years (2015–2020). The most investigated types were those isolated from umbilical cord blood (hUCB-MSCs), adipose tissue (hAT-MSCs) and bone marrow (hBM-MSCs). The most studied diseases were wounds and ulcers, burns and psoriasis. At preclinical level, in vivo studies with mice and rats were the main animal models used, and a wide range of types of hMSCs were used. Clinical studies analyzed revealed that cell therapy by intravenous administration was the advanced therapy preferred except in the case of wounds and burns where tissue engineering was also reported. Although in most of the clinical trials reviewed results have not been posted yet, safety was high and only local slight adverse events (mild nausea or abdominal pain) were reported. In terms of effectiveness, it was difficult to compare the results due to the different doses administered and variables measured, but in general, percentage of wound’s size reduction was higher than 80% in wounds, Psoriasis Area and Severity Index and Severity Scoring for Atopic Dermatitis were significantly reduced, for scleroderma, parameters such as Modified Rodnan skin score (MRSC) or European Scleroderma Study Group activity index reported an improvement of the disease and for hypertrophic scars, Vancouver Scar Scale (VSS) score was decreased after applying these therapies. On balance, hMSCs used for the treatment of cutaneous diseases is a promising strategy, however, the different experimental designs and endpoints stablished in each study, makes necessary more research to find the best way to treat each patient and disease.
Highlights
LITERATURE SEARCH METHODOLOGYHuman mesenchymal stem cells are non-hematopoietic multipotent adult progenitor cells that are found in multiple tissues
Information about the results is limited and the standardization of a cell dose is difficult, the use of human mesenchymal stem cells (hMSCs) could improve the treatment of patients with these skin conditions, because published results are hopeful
The majority of burn injuries are minor and either do not require treatment or can be treated by any caregiver, in the case of severe burns they can lead to a profound systemic response and have serious long-term effects on patients (Porter et al, 2016)
Summary
LITERATURE SEARCH METHODOLOGYHuman mesenchymal stem cells (hMSCs) are non-hematopoietic multipotent adult progenitor cells that are found in multiple tissues. Together with adult skin cells and skin stem cells, the role of hMSCs in normal wound healing is important They can contribute to re-epithelization by stimulating collagen production and reducing fibrosis and scar formation by releasing many growth factors such as epidermal growth factor (EGF), transforming growth factor beta (TGF-β), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) (Stone Ii et al, 2018). For these reasons, the development and research of hMSC based strategies in dermatology have increased in recent years (Figure 1). The objective of this review is to summarize the recent treatments (from 2015 to 2020) based on the use of hMSCs, under research or applied in patients, to treat the most common cutaneous injuries or diseases
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