Engineering of biologic skin substitutes has progressed over time from individual applications of skin cells, or biopolymer scaffolds, to combinations of cells and scaffolds for treatment, healing, and closure of acut...Engineering of biologic skin substitutes has progressed over time from individual applications of skin cells, or biopolymer scaffolds, to combinations of cells and scaffolds for treatment, healing, and closure of acute and chronic skin wounds. Skin substitutes may be categorized into three groups: acellular scaffolds, temporary substitutes containing allogeneic skin cells, and permanent substitutes containing autologous skin cells. Combined use of acellular dermal substitutes with permanent skin substitutes containing autologous cells has been shown to provide definitive wound closure in burns involving greater than 90% of the total body surface area. These advances have contributed to reduced morbidity and mortality from both acute and chronic wounds but, to date, have failed to replace all of the structures and functions of the skin. Among the remaining deficiencies in cellular or biologic skin substitutes are hypopigmentation, absence of stable vascular and lymphatic networks, absence of hair follicles, sebaceous and sweat glands, and incomplete innervation. Correction of these deficiencies depends on regulation of biologic pathways of embryonic and fetal development to restore the full anatomy and physiology of uninjured skin. Elucidation and integration of developmental biology into future models of biologic skin substitutes promises to restore complete anatomy and physiology, and further reduce morbidity from skin wounds and scar. This article offers a review of recent advances in skin cell thrapies and discusses the future prospects in cutaneous regeneration.展开更多
Burns,with their high incidence and mortality rates,have a devastating effect on patients.There are still huge challenges in the management of burns.Mesenchymal stem cells(MSCs),which have multidirectional differentia...Burns,with their high incidence and mortality rates,have a devastating effect on patients.There are still huge challenges in the management of burns.Mesenchymal stem cells(MSCs),which have multidirectional differentiation potential,have aroused interest in exploring the capacity for treating different intractable diseases due to their strong proliferation,tissue repair,immune tolerance and paracrine abilities,among other features.Currently,several animal studies have shown that MSCs play various roles and have beneficial effects in promoting wound healing,inhibiting burn inflammation and preventing the formation of pathological scars during burn healing process.The substances MSCs secrete can act on peripheral cells and promote burn repair.According to preclinical research,MSC-based treatments can effectively improve burn wound healing and reduce pain.However,due to the small number of patients and the lack of controls,treatment plans and evaluation criteria vary widely,thus limiting the value of these clinical studies.Therefore,to better evaluate the safety and effectiveness of MSC-based burn treatments,standardization of the application scheme and evaluation criteria of MSC therapy in burn treatment is required in the future.In addition,the combination of MSC pretreatment and dressing materials are also conducive to improving the therapeutic effect of MSCs on burns.In this article,we review current animal research and clinical trials based on the use of stem cell therapy for treating burns and discuss the main challenges and coping strategies facing future clinical applications.展开更多
目的总结分析大面积特重度烧伤"干"转"湿"治疗的关键节点及技术要领。方法对2012年1月至2018年12月来自中国、埃及、印尼、菲律宾的5家医疗中心的37例早期行干燥疗法治疗的大面积特重度烧伤患者改用烧伤创疡再生医...目的总结分析大面积特重度烧伤"干"转"湿"治疗的关键节点及技术要领。方法对2012年1月至2018年12月来自中国、埃及、印尼、菲律宾的5家医疗中心的37例早期行干燥疗法治疗的大面积特重度烧伤患者改用烧伤创疡再生医疗技术治疗,观察治疗效果:结果 37例患者中,除1例伴有严重多发复合伤患者于治疗第25天死于肺部耐药菌感染外,其余36例患者均顺利完成"干"转"湿"治疗,创面于治疗第17-76 d [(39.5±11.2) d]愈合,住院费用为(13.52±6.30)万元。结论早期行干燥疗法治疗的大面积特重度烧伤患者改用烧伤创疡再生医疗技术治疗,能够实现"干"转"湿"的治疗目的,且疗效显著,安全可靠,值得临床借鉴。展开更多
文摘Engineering of biologic skin substitutes has progressed over time from individual applications of skin cells, or biopolymer scaffolds, to combinations of cells and scaffolds for treatment, healing, and closure of acute and chronic skin wounds. Skin substitutes may be categorized into three groups: acellular scaffolds, temporary substitutes containing allogeneic skin cells, and permanent substitutes containing autologous skin cells. Combined use of acellular dermal substitutes with permanent skin substitutes containing autologous cells has been shown to provide definitive wound closure in burns involving greater than 90% of the total body surface area. These advances have contributed to reduced morbidity and mortality from both acute and chronic wounds but, to date, have failed to replace all of the structures and functions of the skin. Among the remaining deficiencies in cellular or biologic skin substitutes are hypopigmentation, absence of stable vascular and lymphatic networks, absence of hair follicles, sebaceous and sweat glands, and incomplete innervation. Correction of these deficiencies depends on regulation of biologic pathways of embryonic and fetal development to restore the full anatomy and physiology of uninjured skin. Elucidation and integration of developmental biology into future models of biologic skin substitutes promises to restore complete anatomy and physiology, and further reduce morbidity from skin wounds and scar. This article offers a review of recent advances in skin cell thrapies and discusses the future prospects in cutaneous regeneration.
基金supported by the National Natural Science Foundation of China(Grant No.31771065)Sichuan Provincial Science and Technology Program(Grant No.2019JDRC0020)the 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(Grant No.ZYJC18002).
文摘Burns,with their high incidence and mortality rates,have a devastating effect on patients.There are still huge challenges in the management of burns.Mesenchymal stem cells(MSCs),which have multidirectional differentiation potential,have aroused interest in exploring the capacity for treating different intractable diseases due to their strong proliferation,tissue repair,immune tolerance and paracrine abilities,among other features.Currently,several animal studies have shown that MSCs play various roles and have beneficial effects in promoting wound healing,inhibiting burn inflammation and preventing the formation of pathological scars during burn healing process.The substances MSCs secrete can act on peripheral cells and promote burn repair.According to preclinical research,MSC-based treatments can effectively improve burn wound healing and reduce pain.However,due to the small number of patients and the lack of controls,treatment plans and evaluation criteria vary widely,thus limiting the value of these clinical studies.Therefore,to better evaluate the safety and effectiveness of MSC-based burn treatments,standardization of the application scheme and evaluation criteria of MSC therapy in burn treatment is required in the future.In addition,the combination of MSC pretreatment and dressing materials are also conducive to improving the therapeutic effect of MSCs on burns.In this article,we review current animal research and clinical trials based on the use of stem cell therapy for treating burns and discuss the main challenges and coping strategies facing future clinical applications.
文摘目的总结分析大面积特重度烧伤"干"转"湿"治疗的关键节点及技术要领。方法对2012年1月至2018年12月来自中国、埃及、印尼、菲律宾的5家医疗中心的37例早期行干燥疗法治疗的大面积特重度烧伤患者改用烧伤创疡再生医疗技术治疗,观察治疗效果:结果 37例患者中,除1例伴有严重多发复合伤患者于治疗第25天死于肺部耐药菌感染外,其余36例患者均顺利完成"干"转"湿"治疗,创面于治疗第17-76 d [(39.5±11.2) d]愈合,住院费用为(13.52±6.30)万元。结论早期行干燥疗法治疗的大面积特重度烧伤患者改用烧伤创疡再生医疗技术治疗,能够实现"干"转"湿"的治疗目的,且疗效显著,安全可靠,值得临床借鉴。
