脂肪源性干细胞在慢性创面愈合中的作用及研究进展

The role and research progress of adipose derived stem cells in chronic wound healing

随着人口老龄化,糖尿病等慢性病发病率逐年增长,预计慢性创面患者数量将显著增加。然而,现有的治疗方法,譬如创面保守清洁换药、负压封闭治疗、清创后皮片或皮瓣移植手术等往往都难以获得令人满意的伤口愈合。一种被认为特别有前景的治疗策略是利用脂肪源性干细胞(ADSCs)。ADSCs具有分化成多种细胞系的能力,被认为是骨髓间充质干细胞(BMSCs)的替代品。它们可以简单地从脂肪组织中提取,并且能够在体外扩增。本文旨在概述ADSCs的特性以及其治疗慢性创面的作用机制、基础研究及可能的临床应用。综述的实验研究表明,ADSCs可通过增加胶原分泌和沉积、促进上皮化、促新生血管生成以及参与免疫调节等方面来促进慢性创面愈合。此外,目前已有的小型临床试验表明,对慢性创面患者进行ADSCs治疗可降低疼痛评分,改善跛行步行距离,加快创面愈合速度,且均无并发症报告。由此可见,ADSCs在慢性创面治疗中具有广阔的应用前景。然而,需要更大规模的研究证实其对慢性创面患者的疗效和长期安全性。

With the aging of the population,the incidence of chronic diseases such as diabetes is increasing year by year,and the number of patients with chronic wounds is expected to increase significantly.However,the existing treatment methods,such as conservative cleaning and dressing change of wound surface,negative pressure sealing treatment,skin graft or flap transplantation after debridement,are often difficult to achieve satisfactory wound healing.One treatment strategy considered particularly promising is the use of adipose-derived stem cells(ADSCs).ADSCs have the ability to differentiate into multiple cell lines and are considered as substitutes for bone marrow mesenchymal stem cells(BMSCs).They can be easily extracted from adipose tissue and can be amplified in vitro.The purpose of this review is to summarize the characteristics of ADSCs,its mechanism of action,basic research and possible clinical application in the treatment of chronic wounds.The experimental studies reviewed suggest that ADSCs can promote chronic wound healing by increasing collagen secretion and deposition,promoting epithelialization,promoting neovascularization,and participating in immune regulation.In addition,existing small clinical trials have shown that ADSCs treatment for patients with chronic wounds can reduce pain scores,improve walking distance of claudication,and accelerate wound healing,with no reported complications.In conclusion,ADSCs has a broad application prospect in the treatment of chronic wounds.However,larger studies are needed to confirm its efficacy and long-term safety in patients with chronic wounds.