Use of Human Umbilical Cord and Its Byproducts in Tissue Regeneration

Velarde, Francesca; Castañeda, Verónica; Morales, Emilia; Ortega, Mayra; Ocaña, E Rodríguez; Alvarez-Barreto, Jose F.; Grunauer, Michelle; Eguiguren, Luis; Caicedo, Andrés

doi:10.3389/fbioe.2020.00117

Cited by 20 publications

(17 citation statements)

References 91 publications

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“…Four components of the human umbilical cord (HUC) have been identified. The amniotic epithelial membrane (AM), the sub-amnion or "cord lining" (SA), Wharton's Jelly (WJ), and the perivascular region (PV) surrounding the umbilical blood vessels [28]. Each compartment has been described to contain mesenchymal stem cells (MSCs) with different characteristics.…”

Section: Human Umbilical Cord/amniotic Membranementioning

confidence: 99%

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Topical Biological Agents as Adjuncts to Improve Wound Healing in Chronic Diabetic Wounds: A Systematic Review of Clinical Evidence and Future Directions

Wong¹,

Ong²,

Lee³

et al. 2022

Cureus

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Diabetes is a leading chronic illness in the modern world and 19-34% develop chronic diabetic foot ulcers (DFUs) in their lifetime, often necessitating amputation. The reduction in tissue growth factors and resulting imbalance between proteolytic enzymes and their inhibitors, along with systemic factors impairing healing appear particularly important in chronic wounds. Growth factors applied topically have thus been suggested to be a non-invasive, safe, and cost-effective adjunct to improve wound healing and prevent complications.Comprehensive database searches of MEDLINE via PubMed, EMBASE, Cochrane, and ClinicalTrials.gov were performed to identify clinical evidence and ongoing trials. The risk of bias analysis included randomized controlled trials (RCTs) was performed using the Cochrane Risk of Bias 2.0 tool. We included randomized controlled trials that compared the use of a topical biologic growth factor-containing regimen to any other regimen. Primary outcomes of interest were time to wound closure, healing rate, and time. Secondary outcomes included the incidence of adverse events such as infection.A total of 41 trials from 1992-2020 were included in this review, with a total recorded 3,112 patients. Platelet-derived growth factors (PDGF) in the form of becaplermin gel are likely to reduce the time of closure, increase the incidence of wound closure, and complete wound healing. Human umbilical cordrelated treatments, dehydrated human amnion and chorion allograft (dHACA), and hypothermically stored amniotic membrane (HSAM), consistently increased the rates and incidence of complete ulcer healing while reducing ulcer size and time to complete ulcer healing. Fibroblast growth factor-1 (FGF1) showed only a slight benefit in multiple studies regarding increasing complete ulcer healing rates and incidence while reducing ulcer size and time to complete ulcer healing, with a few studies showing no statistical difference from placebo. Platelet-rich fibrin (PRF) is consistent in reducing the time to complete ulcer healing and increasing wound healing rate but may not reduce ulcer size or increase the incidence of complete ulcer healing.Targeting the wound healing pathway via the extrinsic administration of growth factors is a promising option to augment wound healing in diabetic patients. Growth factors have also shown promise in specific subgroups of patients who are at risk of significantly impaired wound healing such as those with a history of secondary infection and vasculopathy. As diabetes impairs multiple stages of wound healing, combining growth factors in diabetic wound care may prove to be an area of interest. Evidence from this systematic literature review suggests that topical adjuncts probably reduce time to wound closure, reduce healing time, and increase the healing rate in patients with chronic DFUs.

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Section: Human Umbilical Cord/amniotic Membranementioning

confidence: 99%

“…The first reported use of HUC was as a patch to successfully treat gastroschisis in pediatric surgery [28]. Since then, it has become a tissue of great and increasing interest in regenerative medicine.…”

Section: Human Umbilical Cord/amniotic Membranementioning

confidence: 99%

Topical Biological Agents as Adjuncts to Improve Wound Healing in Chronic Diabetic Wounds: A Systematic Review of Clinical Evidence and Future Directions

Wong¹,

Ong²,

Lee³

et al. 2022

Cureus

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“…In this direction, human umbilical vessels may be an alternative source for the production of SDVGs [ 196 ]. The human umbilical cord (hUC) contains approximately two arteries and one vein, which are mediating in gas exchange and nutrient supply through the fetomaternal circulation [ 197 ]. The human umbilical arteries (hUAs) are responsible for the transportation of non-oxygenated blood from the fetus to the mother, while the human umbilical vein (hUV) performs exactly the opposite process [ 198 ].…”

Section: Decellularized Vascular Graftsmentioning

confidence: 99%

“…The HUAs and hUVs are characterized by three layers, the inner (tunica intima), the media (tunica media), and the external layer (tunica adventitia). In addition, the hUAs and hUV are vessels without branches and their entire length can be varied and is dependent on hUCs length [ 197 ]. The length of a typical hUC is 20–60 cm and is characterized by an average number of 40 helical turns.…”

Section: Decellularized Vascular Graftsmentioning

confidence: 99%

Future Perspectives in Small-Diameter Vascular Graft Engineering

et al. 2020

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The increased demands of small-diameter vascular grafts (SDVGs) globally has forced the scientific society to explore alternative strategies utilizing the tissue engineering approaches. Cardiovascular disease (CVD) comprises one of the most lethal groups of non-communicable disorders worldwide. It has been estimated that in Europe, the healthcare cost for the administration of CVD is more than 169 billion €. Common manifestations involve the narrowing or occlusion of blood vessels. The replacement of damaged vessels with autologous grafts represents one of the applied therapeutic approaches in CVD. However, significant drawbacks are accompanying the above procedure; therefore, the exploration of alternative vessel sources must be performed. Engineered SDVGs can be produced through the utilization of non-degradable/degradable and naturally derived materials. Decellularized vessels represent also an alternative valuable source for the development of SDVGs. In this review, a great number of SDVG engineering approaches will be highlighted. Importantly, the state-of-the-art methodologies, which are currently employed, will be comprehensively presented. A discussion summarizing the key marks and the future perspectives of SDVG engineering will be included in this review. Taking into consideration the increased number of patients with CVD, SDVG engineering may assist significantly in cardiovascular reconstructive surgery and, therefore, the overall improvement of patients’ life.

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“…Numerous studies are currently carried out on MSCs to treat neurodegenerative or immune-derived inflammatory diseases [ 1 , 4 , 5 ]. MSCs can be isolated from adult tissues (e.g., bone marrow (BM), adipose tissue (AD), skeletal muscle (SM), and dental pulp (DP)) [ 6 – 9 ] or fetal tissues (e.g., placenta, amniotic fluid (AF), Wharton jelly (WJ), and umbilical cord (UC)) [ 10 , 11 ]. Epidermal stem cells, multipotent skin-derived precursors, and other stem cells can also be efficiently isolated from human skin [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Insight in Hypoxia-Mimetic Agents as Potential Tools for Mesenchymal Stem Cell Priming in Regenerative Medicine

Nowak-Stępniowska

Osuchowska

Fiedorowicz

et al. 2022

Stem Cells International

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Hypoxia-mimetic agents are new potential tools in MSC priming instead of hypoxia incubators or chambers. Several pharmaceutical/chemical hypoxia-mimetic agents can be used to induce hypoxia in the tissues: deferoxamine (DFO), dimethyloxaloylglycine (DMOG), 2,4-dinitrophenol (DNP), cobalt chloride (CoCl2), and isoflurane (ISO). Hypoxia-mimetic agents can increase cell proliferation, preserve or enhance differentiation potential, increase migration potential, and induce neovascularization in a concentration- and stem cell source-dependent manner. Moreover, hypoxia-mimetic agents may increase HIF-1α, changing the metabolism and enhancing glycolysis like hypoxia. So, there is clear evidence that treatment with hypoxia-mimetic agents is beneficial in regenerative medicine, preserving stem cell capacities. These agents are not studied so wildly as hypoxia but, considering the low cost and ease of use, are believed to find application as pretreatment of many diseases such as ischemic heart disease and myocardial fibrosis and promote cardiac and cartilage regeneration. The knowledge of MSC priming is critical in evaluating safety procedures and use in clinics. In this review, similarities and differences between hypoxia and hypoxia-mimetic agents in terms of their therapeutic efficiency are considered in detail. The advantages, challenges, and future perspectives in MSC priming with hypoxia mimetic agents are also discussed.

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Use of Human Umbilical Cord and Its Byproducts in Tissue Regeneration

Cited by 20 publications

References 91 publications

Topical Biological Agents as Adjuncts to Improve Wound Healing in Chronic Diabetic Wounds: A Systematic Review of Clinical Evidence and Future Directions

Topical Biological Agents as Adjuncts to Improve Wound Healing in Chronic Diabetic Wounds: A Systematic Review of Clinical Evidence and Future Directions

Future Perspectives in Small-Diameter Vascular Graft Engineering

Insight in Hypoxia-Mimetic Agents as Potential Tools for Mesenchymal Stem Cell Priming in Regenerative Medicine

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