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Review
. 2017:2017:5217967.
doi: 10.1155/2017/5217967. Epub 2017 Oct 29.

Advances of Stem Cell Therapeutics in Cutaneous Wound Healing and Regeneration

Suman Kanji  1 , Hiranmoy Das  2
Affiliations
Review

Advances of Stem Cell Therapeutics in Cutaneous Wound Healing and Regeneration

Suman Kanji et al. Mediators Inflamm. 2017.

Abstract

Cutaneous wound healing is a complex multiple phase process, which overlaps each other, where several growth factors, cytokines, chemokines, and various cells interact in a well-orchestrated manner. However, an imbalance in any of these phases and factors may lead to disruption in harmony of normal wound healing process, resulting in transformation towards chronic nonhealing wounds and abnormal scar formation. Although various therapeutic interventions are available to treat chronic wounds, current wound-care has met with limited success. Progenitor stem cells possess potential therapeutic ability to overcome limitations of the present treatments as it offers accelerated wound repair with tissue regeneration. A substantial number of stem cell therapies for cutaneous wounds are currently under development as a result of encouraging preliminary findings in both preclinical and clinical studies. However, the mechanisms by which these stem cells contribute to the healing process have yet to be elucidated. In this review, we emphasize on the major treatment modalities currently available for the treatment of the wound, role of various interstitial stem cells and exogenous adult stem cells in cutaneous wound healing, and possible mechanisms involved in the healing process.

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Figures

Figure 1
Figure 1
Graphical presentation of stem cell-mediated effect on refractory wound healing process. (a) Phase I: in inflammatory phase, the wound bed contains a large number of neutrophils, early phase macrophages, platelet plugs, and fibrin clots. Initiation of healing process occurs at this phase. (b) Phase II, A: systemic or local administration of stem cell homed to the wound bed. Exogenous stem cells mobilize host resident stem cells to take part in the healing process in GT formation by facilitating angiogenesis. Exogenous stem cells also directly take part in this healing process. The surrounding mobilized fibroblasts also differentiate into myofibroblasts and with collagen deposition facilitate reepithelialization process. B: in the absence of stem cell therapy, inflammatory cells such as neutrophils and macrophages still remain within the wound bed and impaired recruitment of endogenous stem cells occurs, which mediate an imbalance in the orchestrated harmony. GT formation is hindered due to the lack of angiogenesis, myofibroblast differentiation, collagen deposition, and reepithelialization. (c) Phase III: stem cell therapy generates scar tissue within the wound by replacing the provisional matrix. However, without stem cell therapy, refractory condition remains. The wound bed remains enriched with inflammatory cells and their proinflammatory secretory products. IL: interleukin; VEGF: vascular endothelial growth factor; PDGF: platelet-derived growth factor; TGF-β: transforming growth factor beta; MMP: matrix metalloproteinase.
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