Scarring, stem cells, scaffolds and skin repair

Abstract

The treatment of full thickness skin loss, which can be extensive in the case of large burns, continues to represent a challenging clinical entity. This is due to an on-going inability to produce a suitable tissue engineered substrate that can satisfactorily replicate the epidermal and dermal in vivo niches to fulfil both aesthetic and functional demands. The current gold standard treatment of autologous skin grafting is inadequate because of poor textural durability, scarring and associated contracture, and because of a paucity of donor sites in larger burns. Tissue engineering has seen exponential growth in recent years with a number of 'off-the-shelf' dermal and epidermal substitutes now available. Each has its own limitations. In this review, we examine normal wound repair in relation to stem/progenitor cells that are intimately involved in this process within the dermal niche. Endothelial precursors, in particular, are examined closely and their phenotype, morphology and enrichment from multiple sources are described in an attempt to provide some clarity regarding the controversy surrounding their classification and role in vasculogenesis. We also review the role of the next generation of cellularized scaffolds and smart biomaterials that attempt to improve the revascularisation of artificial grafts, the rate of wound healing and the final cosmetic and functional outcome.

Delivery of Mesenchymal Stem Cells in Biomimetic Engineered Scaffolds Promotes Healing of Diabetic Ulcers

“…Current tissue engineering approaches to advanced wound care therapy have been to enhance these processes via delivery of either matrixbased or cell-based scaffolds. Matrix [7][8][9]. Although these products promote wound healing, no treatment paradigm has shown superior long-term efficacy [8].…”

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“…Skin regeneration using stem cell based tissue engineering is not lagging behind. Skin autografts are the current gold standard, but have major drawbacks due to limited availability in case of severe burns and scar contracture, sensory loss of grafted skin and unsatisfactory aesthetic outcome [16]. Deculleruzised human or porcine dermis is already commercially available for use in traumatic injuries, burns and skin damage caused by diabetes, but unless vascularized the tissue would die and serve more as covering than as a regenerator.…”

Proteomics Characterization of Primary Human Oral Epithelial Cells Using a Novel Culture Technique for Use in Tissue Regeneration

“…The understanding of a cultured undifferentiated cell population might provide novel insights to tissue engineering where sustaining the cellular capacity of growth, proliferation and mobility is a key to the success of regenerative medicine [11]. It has been reported that the majority of the ePUKs are a small-sized population [2], however, in culture supernatant, large-sized differentiated or dead cells are also floating where they have lost their adherent capacity secondary to their differentiation.…”