Adipose-Derived Stromal Cells Seeded on Integra® Dermal Regeneration Template Improve Post-Burn Wound Reconstruction

Abstract

<jats:p>Fibrosis of burn-related wounds remains an unresolved clinical issue that leads to patient disability. The aim of this study was to assess the efficacy of the transplantation of adipose-derived stromal cells seeded onto a collagen-based matrix in the reconstruction of burn-related scars. Here, we characterized an in vitro interaction between adipose-derived stromal cells and a collagen-based matrix, Integra®DRT. Our results show that transcription of pro-angiogenic, remodeling, and immunomodulatory factors was more significant in adipose-derived stromal cells than in fibroblasts. Transcription of metalloproteinases 2 and 9 is positively correlated with the collagenolytic activity of the adipose-derived stromal cells seeded onto Integra®DRT. The increase in the enzymatic activity corresponds to the decrease in the elasticity of the whole construct. Finally, we validated the treatment of a post-excision wound using adipose-derived stromal cells and an Integra®DRT construct in a 25-year-old woman suffering from burn-related scars. Scarless healing was observed in the area treated by adipose-derived stromal cells and the Integra®DRT construct but not in the reference area where Integra®DRT was applied without cells. This clinical observation may be explained by in vitro findings: Enhanced transcription of the vascular endothelial growth factor as well as remodeling of the collagen-based matrix decreased mechanical stress. Our experimental treatment demonstrated that the adipose-derived stromal cells seeded onto Integra®DRT exhibit valuable properties that may improve post-excision wound healing and facilitate skin regeneration without scars.</jats:p>

Mesenchymal Stem Cells in Burn Wound Management

“…No adverse events were reported. The skin in the area treated with ADSC-s-matrix was more elastic and less reddish than in non-treated areas [ 79 ].…”

Recent advances in decellularized biomaterials for wound healing

“… Decellularized materials Product Application Ref. Acellular Dermal Matrix DermACELL AWM® normal and Chronic Wounds [ 221 ] GRAFTJACKET®RTM normal and Chronic Wounds [ 222 ] Integra® normal and Chronic Wounds [ [223] , [224] , [225] ] GRAFTJACKET ® Xpress normal and Chronic Wounds [ 226 ] Alloderm® normal and Chronic Wounds [ [223] , [224] , [225] ] Dermagraft® Diabetic Foot Ulcers [ 223 , 224 , 227 ] TransCyte™ Burn wounds [ [223] , [224] , [225] ] OrCel™ Chronic Wounds [ 223 ] PermaDerm™ Burn wounds [ 223 ] Decellularized adipose tissue Integra® DRT normal and Chronic Wounds [ 159 ] decellularized fish skin Kerecis® Omega3 MicroGraft™ Normal and diabetic [ 223 ] Acellular Amniotic Membrane SURFFIXX Normal, chronic and infectious Wounds [ 179 ] AmnioBand Normal, chronic and infectious Wounds [ 179 ] EpiFix Normal, chronic and infectious Wounds [ …”

“…2 F [ [155] , [156] , [157] , [158] ]). Commercial decellularization products are also currently undergoing extensive research, for instance, Integra® DRT [ 159 ].…”

Cutaneous Wound Healing: An Update from Physiopathology to Current Therapies

“…Cellular skin substitutes have cells in the constitution and although the cells are not necessary to synthesize the skin substitutes, the addition of fibroblasts, keratinocytes, macrophage, endothelial cells, and stem cells improve the control of the regenerative mechanisms [ 98 , 99 , 100 ]. Bioseed-S ® , Epicel ® , EpiDex ® , and MySkin™ are cellular epidermal skin substitutes composed by an autologous cultured keratinocyte layer seeded on scaffolds (silicone, petrolatum gauze, allogeneic fibrin), mimicking the epidermal barrier [ 97 , 101 ].…”