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Adipose-Derived Stem Cells for Wound Healing: An Update

Chapter
Part of the Stem Cells in Clinical Applications book series (SCCA)

Abstract

Chronic wound healing is a serious problem worldwide, causing acute discomfort and affecting patients with various wound types, including but not restricted to diabetic foot ulcers, pressure ulcers, venous leg ulcers, burns, and traumatic injuries. The general pattern is a cycle of healing and recurrence, which has a considerable impact on an individual’s health and quality of life. Complications include infection, amputation, and even death. Advanced therapies help a proportion of patients, but up to 50 % of chronic wounds still fail to heal after treatment, and even more are at risk of recurrence.

Regenerative medicine has tried to respond to the need for new methods which improve the healing process, in order to reach favorable outcomes. Thus, over the last few years, stem cells application has been put forward as a promising novel therapy and different types of stem cells have since been studied. Mesenchymal stem cells obtained from adipose tissue have revealed strong tissue healing potential in both in vitro and in vivo studies, as they are attracted to the wound site and stimulate regeneration processes. Adipose-derived stem cells (ADSCs) are abundant and harvestable via a minimally invasive procedure, providing an elevated yield when isolated and proving suitable for clinical application without prior manipulation.

The most commonly used ADSCs isolation technique is that described in 1995 by Coleman in a stepwise procedure. The administration of ADSCs to chronic wounds enhances the regenerative wound microenvironment, promoting increased accelerated wound closure, reduced scarring, collagen synthesis, angiogenesis, and improved tensile strength. However, the number of cells that need to be harvested for effective implantation is not clear from the literature. Therefore, standardized, reliable, fast, and efficient protocols are required before large clinical trials are carried out.

Herein, the isolation technique for ADSCs is described, and preclinical and clinical applications on chronic wounds caused by several pathologies are reviewed.

Keywords

Wound healing Chronic wounds Stem cell therapy Mesenchymal stem cells Autologous adipose tissue Regenerative medicine Coleman’s technique 

Abbreviations

ADMSC

Adipose tissue-derived mesenchymal stem cell

ADRCs

Purified adipose-derived stem and regenerative cells

ADSCs

Adipose-derived stem cells

ASCs

Adipose-derived stromal cells

ASCs

Adipose-derived stem cells

bFGF

Basic fibroblast growth factor

e-PRP

Enhanced PRP

ECM

Extracellular matrix

FGF

Fibroblast growth factor

GSK-3β/Fyn/Nrf2

Glycogen synthase kinase-3β/Fyn kinase/nuclear factor erythroid 2-related factor 2

HA

Hyaluronic acid

HGF

Hepatocyte growth factor

IGF

Insulin-like growth factor

KGF

Keratinocyte growth factor

MMPs

Matrix metalloproteinases

MMP9

Matrix metalloproteinase

PDGF

Platelet-derived growth factor

PGA

Polyglycolic acid

PRP

Platelet-rich plasma

ROS

Reactive oxygen species

SDF

Stromal cell-derived factor

TGF-A1 and TGF-2

Transforming growth factor-A1 and Transforming growth factor-2

TGF-β

Transforming growth factor-beta

TIME protocol

Tissue, infection, moisture, environment protocol

TNF

Tumor necrosis factor

TNF-α

Tumor necrosis factor-alpha

VEGF

Vascular endothelial growth factor

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and SurgeryUniversity of FerraraFerraraItaly
  2. 2.Sant’Anna University Hospital, Vascular Diseases Center and Institute of Translational Medicine and Surgery, University of FerraraFerraraItaly

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