Role of growth factors and biomaterials in wound healing

Figures & data

Table 1. Factors affecting chronic wounds.

Specific factors	Physiological factors
Exposure of wound to bacteria, viral or parasitic infections	Aging process can lead to development chronic wound
Reduced blood and oxygen flow to a wound	Chronic diseases such as cancer and genetic disorder diseases.
Presence of cancerous cells	Presence of alcohol and cannabis
Exposure of wound to radiation	Taking harmful drugs can lead to chronic wound
Trauma	Nutritional deficiencies
Secretion of local toxins	Presence of urea in the blood
Arterial/venous insufficiency	Impairment in the functions of the peripheral nerve

Adapted from [46] with copyright permission.

Figure 1. Showing potential mechanism of skin repair by ASCs. This figure was adapted from [46] with copyright permission.

Table 2. Showing applications of ASCs in wound healing.

Reference	Methods
[11]	Shows the application of ASCs in the formulation of collagen gel
[24]	Demonstrated the use of ASCs in the design of an atelocollagen scaffold
[47]	Demonstrated the use of ASCs in the design of a silk fibroin scaffold
[25]	Reported the injection of ASCs
[18]	Reported the direct injection of ASCs
[29]	Reported the injection of ASCs
[21]	Reported the application of noncultured ASCs in the formulation of an atelocollagen matrix
[30]	Reported the use of ASCs in platelet-rich plasma
[32]	Demonstrated the direct injection of ASCs into chronic wounds
[33]	Demonstrated the direct injection of ASCs into chronic wounds
[34]	Demonstrated the injection of ASCs into flap
[38]	Demonstrated the direct injection of ASCs around the wound site
[40]	Reported the use of ASCs in the formulation of collagen gels
[42]	Showed the application of ASCs on acellular dermal matrix
[43]	Formulated a conditioned medium of genetically modified ASCs

Adapted from [46] with copyright permission.

Table 3. Showing clinical trials, involving the use of ADSCs.

Clinical trials	Clinical trial number
Allogenic ADSCs in Crohn’s Fistula	NCT01440699
Autologous Cultured ADSCs on Complex and Crohn’s Fistula	NCT01314092
Development of Bone Grafts Using ADSCs and Different Scaffolds	NCT01218945
ADSCs to Treat Complex Perianal Fistulas	NCT01020825
Safety and Effects of Autologous Adipose-Derived Stromal Cells Delivered in Patients with Renal Failure	NCT01453816
Human Adipose-Derived MSCs for Critical Limb Ischemia in Diabetic Patients	NCT01257776
Autologous ADSCs in Patients after Stroke	NCT01453829
Autologous-Cultured Adipocytes in Patient with Depressed Scar	NCT00992147

Adapted from https://clinicaltrials.gov.

Table 4. Showing application of growth factors and cytokines in wounds healing.

Growth factor	Brand name	Administration	Wound type
Recombinant human granulocyte-macrophage colony-stimulating factor	Leukine	Subcutaneous injection	Chronic venous ulcers
Recombinant human granulocyte colony-stimulating factor	Leucomax		Second-degree burns
			Diabetic foot ulcers
Recombinant human platelet-derived growth factor	Regranex	Topical	Diabetic foot ulcers
			Pressure ulcers
Recombinant human vascular endothelial growth factor.	Telbermin	Topical	Diabetic foot ulcers
Recombinant human basic fibroblast growth factor.	N/A	Topical	Pressure ulcers

Adapted from [48] with copyright permission.

Table 5. Showing the application of chitin in wound healing.

Biomaterials	Cells/Animals	Results	Reference
Chitin	Fibroblast	Chitin demonstrated no positive effects on proliferation	[50]
Chitin	3T6	Migratory process is inhibited by chitin, chitosan.	[51]
Chitin	HUVECs	Migratory actions were improved by chitin and chitosan	[51]
Chitin	Bovine PMNs	The biomaterials activated bovine poly morphonuclear cells	[51]
Chitin	Canine PMNs	The biomaterials activated canine poly morphonuclear cells	[52]
Chitin	Canine PMNs	They are induced complement-mediated chemotactic actions	[53]
Chitin	Canine PMNs	Supernatants of canine polymorphonuclear cells incubated with chitin	[54]
Chitin	Macrophage	Chitin is a size-dependent stimulator of macrophage IL-17A production and its receptor expression	[55]
Chitin	Dog	Numbers of MN and polymorphonuclear neutrophils cells were bigger in the chitin group than in the control group.	[56]
Chitin-sponge	Dog, cow, cats	Chitin-sponges were used in 30 study cases as filling agents for surgical tissue defects.	[57]
Chitin-cotton	Dog, cow, cats	Chitin-cotton was used in 8 cases of trauma and 12 cases of abscess as a wound dressing	[57]
Chitin-flake	Dog, cow, cats	Chitin-flake was used in 9 cases of trauma as a wound dressing.	[57]
Chitin/NWF	Dog	The quantity of PGE2 in the exudate induced by chitin was about five times as high as that in the exudate induced by chitin.	[56]
Chitin	Dog	Chitin activated the complement components C3 and C5, but not C4	[58]

Adapted from [49] with copyright permission.

Table 6. Selected applications of chitosan as a wound-dressing biomaterial.

Delivery method	Results	References
Hydrogels	Fast-tracked wound healing by fibroblast cell proliferation from rat skin	[60]
Films	Chitosan species of low degree of deacetylation induce adhesion and proliferationin children foreskin keratinocytes and fibroblasts	[61]
Hydrogels	Rapid haemostasis in mice	[62]
	Fast-tracked wound healing	[62]
	Fast-tracked wound healing	[63]
	Skin reconstruction following a burn on a swine skin	[64]
	Reduced healing time and accelerated re-epithelialization in rats	[65]
Gel powder	Full-thickness of cartilage healing therapy in rabbits	[66]
	Chronic udder trauma close to the nipples in cows	[67]
Dressing material	Fast wound healing in human subjects	[68]
Membranes	Fast wound healing in human trials	[68]
Artificial skin	Total colonization by fibroblasts in human subjects	[69]

This table was adapted from [59] with copyright permission.

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