Stem cell therapies for wound healing

ABSTRACT

Introduction: Aberrant wound healing is a significant healthcare problem, posing a substantial burden on patients, their families, and the healthcare system. Existing treatment options remain only moderately effective and often fail to promote the closure of non-healing wounds in susceptible populations, such as aging and diabetic patients. Stem cell therapy has emerged as a promising treatment modality, with the potential to restore tissue to its pre-injured state. Of particular interest are mesenchymal stromal cells, which have been shown to accelerate wound healing by modulating the immune response and promoting angiogenesis.

Areas covered: This review provides an overview of wound healing and current methods for the management of chronic wounds, as well as the current state and considerations for optimizing stem cell therapy. Considerations include stem cell types, tissue source, donor selection, cell heterogeneity, delivery methods, and genetic engineering.

Expert opinion: A growing body of evidence has shown that delivery of stem cells, particularly mesenchymal stromal cells, has the potential to effectively improve the rate and quality of wound healing. However, significant additional basic and clinical research must be performed to optimize cell therapy, such as further elucidation of the therapeutic mechanisms of stem cells and standardization of clinical trial guidelines.

Trial registration: ClinicalTrials.gov identifier: NCT02104713.

Trial registration: ClinicalTrials.gov identifier: NCT02961699.

Trial registration: ClinicalTrials.gov identifier: NCT02394873.

Trial registration: ClinicalTrials.gov identifier: NCT02590042.

Trial registration: ClinicalTrials.gov identifier: NCT03686449.

Trial registration: ClinicalTrials.gov identifier: NCT03257098.

KEYWORDS:

• Adipose stem cells
• cellular heterogeneity
• chronic wounds
• genetic engineering
• mesenchymal stromal cells
• stem cells
• wound healing

Article Highlights

• Currently available treatments for wound care are ineffective for reversing deficiencies that contribute to chronic wounds

• Stem cell therapy is a promising treatment modality for wound care due to the ability of stem cells to secrete cytokines and growth factors beneficial for wound healing

• Mesenchymal stromal cells can be readily isolated from multiple tissue sources and their application has yielded substantial therapeutic benefit for wound healing

• The therapeutic mechanism of mesenchymal stromal cell therapy is multifactorial and includes immunomodulation and promotion of regenerative processes

• Considerations for stem cell therapy include selection of donors and tissue source, unraveling cellular heterogeneity, and optimizing cell delivery methods

This box summarizes key points contained in the article.

Declaration of interest

G Gurtner is supported in the form of grants, sponsorship or materials from the Hagey Family Program and Johnson and Johnson Professorship. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.