Mesenchymal stem cell therapy in skin: why and what for?

Abstract

In recent years, few stem cells have gained as much clinical notoriety as mesenchymal stem cells. Indeed, MSCs are already in use for a range of systemic inflammatory and autoimmune conditions that also affect the skin, such as acute and chronic graft versus host disease or lupus erythematosus. Most interestingly, these cells are able to improve skin wound healing in multiple preclinical models and few patient series. An additional potential of these cells is the delivery of missing structural elements in skin inherited disorders. However, we here contend that MSCs are not appropriate for cell replacement therapies in the context of wound healing. Indeed, engraftment of cells in the dermis is poor in the absence of irradiation and the observed effects seem mainly due to paracrine factors. In this viewpoint, we favour the hypothesis of a replete niche and competition with resident mesenchymal populations in the dermis not allowing the engraftment of newly delivered MSCs. Consequently, we propose that the benefit of MSCs may be at least in part reproduced by the growth factors or immunomodulatory molecules that they produce. In any case, the rapid progress in this field has allowed the emergence of important questions in skin biology that need to be addressed in parallel with the predictable future use of MSCs in the clinic.

Human Wharton’s jelly mesenchymal stem cells promote skin wound healing through paracrine signaling

“…MSC paracrine signaling has been suggested to be the main underlying mechanism for MSCs enhanced wound repair effects [2,22,23]. BM-MSCs have been reported to promote wound healing, but their isolation requires an invasive and artificial method [24,25].…”

“…Paracrine signaling, such as the release of factors that promote angiogenesis, immunomodulation and recruitment of endogenous tissue stem/progenitor cells, as well as differentiation, have been described as possible mechanisms underlying the positive wound healing effects of MSCs [2,3]. From the different available sources of MSCs, the umbilical cord represents a cost-effective, productive, feasible, accepted, and universal source to isolate MSCs, and is considered advantageous compared with bone marrow-derived mesenchymal stem cells (BM-MSCs) and adipose-derived MSCs for some researchers [4].…”

Mesenchymal Stem Cell Therapy in Type 1 Diabetes Mellitus and Its Main Complications: From Experimental Findings to Clinical Practice

“…Successful wound healing is particularly related to the secretion of trophic factors, such as VEGF, IGF-1, bFGF, PDGF-BB, Ang-1, SDF-1, EGF, KGF and MMP9, or cytokines, such as TGF-β, IL6 and IL8. These could contribute towards wound repair and skin regeneration by suppressing inflammation, angiogenesis and stimulating skin stem cell proliferation and differentiation into new keratinocytes [123,131,[135][136][137][138].…”

The importance and use of stem cells in dermatology

“…Prowadzone są również badania nad wykorzystaniem mezenchymalnych komórek skóry w terapii innych schorzeń autoimmunologicznych, takich jak choroba GVH, choroba Leśniowskiego-Crohna, stwardnienie rozsiane i twardzina układowa [26,31].…”