Abstract
Cutaneous wound repair is a highly coordinated cascade of cellular responses to injury which restores the epidermal integrity and its barrier functions. Even under optimal healing conditions, normal wound repair of adult human skin is imperfect and delayed healing and scarring are frequent occurrences. Dysregulated wound healing is a major concern for global healthcare, and, given the rise in diabetic and aging populations, this medicoeconomic disease burden will continue to rise. Therapies to reliably improve nonhealing wounds and reduce scarring are currently unavailable. Mesenchymal stromal cells (MSCs) have emerged as a powerful technique to improve skin wound healing. Their differentiation potential, ease of harvest, low immunogenicity, and integral role in native wound healing physiology make MSCs an attractive therapeutic remedy. MSCs promote cell migration, angiogenesis, epithelialization, and granulation tissue formation, which result in accelerated wound closure. MSCs encourage a regenerative, rather than fibrotic, wound healing microenvironment. Recent translational research efforts using modern bioengineering approaches have made progress in creating novel techniques for stromal cell delivery into healing wounds. This paper discusses experimental applications of various stromal cells to promote wound healing and discusses the novel methods used to increase MSC delivery and efficacy.
Highlights
An open wound is a loss of continuity of the epidermis, caused by mechanical, chemical, biological, or thermal injuries
The International Society for Cellular Therapy (ISCT) attempted to resolve challenges in confirming Mesenchymal stromal cells (MSCs) identity by proposing three minimal criteria for defining human MSCs: (1) the cells must be plastic-adherent when maintained in standard culture conditions using tissue culture flasks; (2) ≥95% of the population must express CD105, CD73, and CD90 and ≤2% must not express CD45, CD34, CD14, CD11b, CD79α, or CD19, and HLA class II surface molecules; and (3) the cells must be able to differentiate into osteoblasts, adipocytes, and chondroblasts under standard in vitro differentiating conditions [40]
dermal papilla cells (DPC) are primarily involved in modulating hair follicle cycling [45, 46], while the dermal sheath cells (DSC) are thought to play a critical role in replacing the dermis in response to injury by differentiating into wound healing fibroblasts [47] (Figure 2)
Summary
An open wound is a loss of continuity of the epidermis, caused by mechanical, chemical, biological, or thermal injuries. Cutaneous wound healing is a highly organized physiological process that restores the integrity of the skin following injury It involves the interplay between various populations of cells and is typically categorized into three overlapping phases: inflammation, proliferation, and maturation [1,2,3]. The ISCT attempted to resolve challenges in confirming MSC identity by proposing three minimal criteria for defining human MSCs: (1) the cells must be plastic-adherent when maintained in standard culture conditions using tissue culture flasks; (2) ≥95% of the population must express CD105, CD73, and CD90 and ≤2% must not express CD45, CD34, CD14, CD11b, CD79α, or CD19, and HLA class II surface molecules; and (3) the cells must be able to differentiate into osteoblasts, adipocytes, and chondroblasts under standard in vitro differentiating conditions [40]. Pericytes are cells located within the vascular basement membrane of microvessels and capillaries throughout the body, which may indicate there is a common precursor cell type in a wide variety of tissues
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