Adipose-derived stem cells in patients with venous ulcers: Systematic review

Abstract

Objectives Few studies have reported on the safety and durability of adipose-derived stem cells (ADSCs) to support healing in patients with venous leg ulcers (VLU). To establish if there is any evidence to support ADSC use in VLU patients, a systematic review was conducted. Methods A systematic review was conducted following the PRISMA guidelines. PubMed and Embase databases were searched for relevant papers. References from retrieved papers were reviewed to identify any extra eligible studies. Results After duplicate removal, 950 papers were screened for eligibility of which 932 were excluded based on title and abstract. Four papers were included in the final analysis (one randomised study and three non-randomised studies). 66 patients in total received ADSCs for VLU treatment. The only randomised paper reported 6-month healing rates of 75% with ADSCs compared to 50% in controls. 100% healing was achieved in one study. The remaining 2 studies reported 25% and 58% healing; however, they included patients with relatively large VLUs. Pain scores decreased after ADSCs application where reported. No serious procedure related complications were reported. Conclusion ADSCs may enhance ulcer healing in patients with chronic VLU and appears safe based on initial reports. Large, randomised trials are needed to definitively establish the technique’s role in VLU patients.

Extracellular Vesicles Derived from Mesenchymal Stem Cells Promote Wound Healing and Skin Regeneration by Modulating Multiple Cellular Changes: A Brief Review

“…MSC-EVs regulate cell differentiation and proliferation, affect angiogenesis, interfere with stress responses, and participate in immune signaling [ 65 ]. A systematic assessment of 66 patients treated with adipose-derived stem cells (ADSCs) for venous leg ulcer (VLU) showed significantly higher wound-healing rates compared to controls, decreased pain scores, and no serious surgery-related complications reported [ 66 ]. Thus, it is speculated that MSCs and MSC-EVs may also contribute to the prognosis, diagnosis, and treatment of chronic wounds by influencing the role of SNPs.…”