Augmentation of Dermal Wound Healing by Adipose Tissue-Derived Stromal Cells (ASC)

The skin is the largest organ of the human body and is the first line of defense against physical and biological damage. Thus, the skin is equipped to self-repair and regenerates after trauma. Skin regeneration after damage comprises a tightly spatial-temporally regulated process of wound healing th...

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Published in:	Bioengineering (Basel) Vol. 5; no. 4; p. 91
Main Authors:	Van Dongen, Joris A., Harmsen, Martin C., Van der Lei, Berend, Stevens, Hieronymus P.
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 26.10.2018 MDPI
Subjects:	Adipocytes adipose derived stromal cells Adipose tissue Amputation Angiogenesis Bioengineering Body fat Clinical trials Cytokines Damage Diabetes Enzymes Extracellular matrix Fibrosis Growth factors Hair Homeostasis Hyperglycemia Inflammation Ischemia lipografting Parenchyma Physiology Regeneration Review Scars Senescence Skin Stem cells Stromal cells stromal vascular fraction Trauma Ulcers Wound healing skin stem cells wound healing stromal vascular fraction adipose derived stromal cells lipografting
ISSN:	2306-5354, 2306-5354
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Abstract	The skin is the largest organ of the human body and is the first line of defense against physical and biological damage. Thus, the skin is equipped to self-repair and regenerates after trauma. Skin regeneration after damage comprises a tightly spatial-temporally regulated process of wound healing that involves virtually all cell types in the skin. Wound healing features five partially overlapping stages: homeostasis, inflammation, proliferation, re-epithelization, and finally resolution or fibrosis. Dysreguled wound healing may resolve in dermal scarring. Adipose tissue is long known for its suppressive influence on dermal scarring. Cultured adipose tissue-derived stromal cells (ASCs) secrete a plethora of regenerative growth factors and immune mediators that influence processes during wound healing e.g., angiogenesis, modulation of inflammation and extracellular matrix remodeling. In clinical practice, ASCs are usually administered as part of fractionated adipose tissue i.e., as part of enzymatically isolated SVF (cellular SVF), mechanically isolated SVF (tissue SVF), or as lipograft. Enzymatic isolation of SVF obtained adipose tissue results in suspension of adipocyte-free cells (cSVF) that lack intact intercellular adhesions or connections to extracellular matrix (ECM). Mechanical isolation of SVF from adipose tissue destructs the parenchyma (adipocytes), which results in a tissue SVF (tSVF) with intact connections between cells, as well as matrix. To date, due to a lack of well-designed prospective randomized clinical trials, neither cSVF, tSVF, whole adipose tissue, or cultured ASCs can be indicated as the preferred preparation procedure prior to therapeutic administration. In this review, we present and discuss current literature regarding the different administration options to apply ASCs (i.e., cultured ASCs, cSVF, tSVF, and lipografting) to augment dermal wound healing, as well as the available indications for clinical efficacy.
AbstractList	The skin is the largest organ of the human body and is the first line of defense against physical and biological damage. Thus, the skin is equipped to self-repair and regenerates after trauma. Skin regeneration after damage comprises a tightly spatial-temporally regulated process of wound healing that involves virtually all cell types in the skin. Wound healing features five partially overlapping stages: homeostasis, inflammation, proliferation, re-epithelization, and finally resolution or fibrosis. Dysreguled wound healing may resolve in dermal scarring. Adipose tissue is long known for its suppressive influence on dermal scarring. Cultured adipose tissue-derived stromal cells (ASCs) secrete a plethora of regenerative growth factors and immune mediators that influence processes during wound healing e.g., angiogenesis, modulation of inflammation and extracellular matrix remodeling. In clinical practice, ASCs are usually administered as part of fractionated adipose tissue i.e., as part of enzymatically isolated SVF (cellular SVF), mechanically isolated SVF (tissue SVF), or as lipograft. Enzymatic isolation of SVF obtained adipose tissue results in suspension of adipocyte-free cells (cSVF) that lack intact intercellular adhesions or connections to extracellular matrix (ECM). Mechanical isolation of SVF from adipose tissue destructs the parenchyma (adipocytes), which results in a tissue SVF (tSVF) with intact connections between cells, as well as matrix. To date, due to a lack of well-designed prospective randomized clinical trials, neither cSVF, tSVF, whole adipose tissue, or cultured ASCs can be indicated as the preferred preparation procedure prior to therapeutic administration. In this review, we present and discuss current literature regarding the different administration options to apply ASCs (i.e., cultured ASCs, cSVF, tSVF, and lipografting) to augment dermal wound healing, as well as the available indications for clinical efficacy. The skin is the largest organ of the human body and is the first line of defense against physical and biological damage. Thus, the skin is equipped to self-repair and regenerates after trauma. Skin regeneration after damage comprises a tightly spatial-temporally regulated process of wound healing that involves virtually all cell types in the skin. Wound healing features five partially overlapping stages: homeostasis, inflammation, proliferation, re-epithelization, and finally resolution or fibrosis. Dysreguled wound healing may resolve in dermal scarring. Adipose tissue is long known for its suppressive influence on dermal scarring. Cultured adipose tissue-derived stromal cells (ASCs) secrete a plethora of regenerative growth factors and immune mediators that influence processes during wound healing e.g., angiogenesis, modulation of inflammation and extracellular matrix remodeling. In clinical practice, ASCs are usually administered as part of fractionated adipose tissue i.e., as part of enzymatically isolated SVF (cellular SVF), mechanically isolated SVF (tissue SVF), or as lipograft. Enzymatic isolation of SVF obtained adipose tissue results in suspension of adipocyte-free cells (cSVF) that lack intact intercellular adhesions or connections to extracellular matrix (ECM). Mechanical isolation of SVF from adipose tissue destructs the parenchyma (adipocytes), which results in a tissue SVF (tSVF) with intact connections between cells, as well as matrix. To date, due to a lack of well-designed prospective randomized clinical trials, neither cSVF, tSVF, whole adipose tissue, or cultured ASCs can be indicated as the preferred preparation procedure prior to therapeutic administration. In this review, we present and discuss current literature regarding the different administration options to apply ASCs (i.e., cultured ASCs, cSVF, tSVF, and lipografting) to augment dermal wound healing, as well as the available indications for clinical efficacy.The skin is the largest organ of the human body and is the first line of defense against physical and biological damage. Thus, the skin is equipped to self-repair and regenerates after trauma. Skin regeneration after damage comprises a tightly spatial-temporally regulated process of wound healing that involves virtually all cell types in the skin. Wound healing features five partially overlapping stages: homeostasis, inflammation, proliferation, re-epithelization, and finally resolution or fibrosis. Dysreguled wound healing may resolve in dermal scarring. Adipose tissue is long known for its suppressive influence on dermal scarring. Cultured adipose tissue-derived stromal cells (ASCs) secrete a plethora of regenerative growth factors and immune mediators that influence processes during wound healing e.g., angiogenesis, modulation of inflammation and extracellular matrix remodeling. In clinical practice, ASCs are usually administered as part of fractionated adipose tissue i.e., as part of enzymatically isolated SVF (cellular SVF), mechanically isolated SVF (tissue SVF), or as lipograft. Enzymatic isolation of SVF obtained adipose tissue results in suspension of adipocyte-free cells (cSVF) that lack intact intercellular adhesions or connections to extracellular matrix (ECM). Mechanical isolation of SVF from adipose tissue destructs the parenchyma (adipocytes), which results in a tissue SVF (tSVF) with intact connections between cells, as well as matrix. To date, due to a lack of well-designed prospective randomized clinical trials, neither cSVF, tSVF, whole adipose tissue, or cultured ASCs can be indicated as the preferred preparation procedure prior to therapeutic administration. In this review, we present and discuss current literature regarding the different administration options to apply ASCs (i.e., cultured ASCs, cSVF, tSVF, and lipografting) to augment dermal wound healing, as well as the available indications for clinical efficacy.
Author	Harmsen, Martin C. Van Dongen, Joris A. Stevens, Hieronymus P. Van der Lei, Berend
AuthorAffiliation	2 Department of Plastic Surgery, University of Groningen and University Medical Centre of Groningen, 9713 GZ Groningen, The Netherlands; info@berendvanderlei.nl 3 Department of Plastic Surgery, Bergman Clinics, Den Haag & Rijswijk, Binckhorstlaan 149, 2516 BA Den Haag, The Netherlands 1 Department of Pathology & Medical Biology, University of Groningen and University Medical Centre of Groningen, 9713 GZ Groningen, The Netherlands; jorisavandongen@gmail.com (J.A.v.D.); m.c.harmsen@umcg.nl (M.C.H.)
AuthorAffiliation_xml	– name: 1 Department of Pathology & Medical Biology, University of Groningen and University Medical Centre of Groningen, 9713 GZ Groningen, The Netherlands; jorisavandongen@gmail.com (J.A.v.D.); m.c.harmsen@umcg.nl (M.C.H.) – name: 2 Department of Plastic Surgery, University of Groningen and University Medical Centre of Groningen, 9713 GZ Groningen, The Netherlands; info@berendvanderlei.nl – name: 3 Department of Plastic Surgery, Bergman Clinics, Den Haag & Rijswijk, Binckhorstlaan 149, 2516 BA Den Haag, The Netherlands
Author_xml	– sequence: 1 givenname: Joris A. surname: Van Dongen fullname: Van Dongen, Joris A. – sequence: 2 givenname: Martin C. orcidid: 0000-0002-7128-2741 surname: Harmsen fullname: Harmsen, Martin C. – sequence: 3 givenname: Berend surname: Van der Lei fullname: Van der Lei, Berend – sequence: 4 givenname: Hieronymus P. surname: Stevens fullname: Stevens, Hieronymus P.
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Copyright	2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2018 by the authors. 2018
Copyright_xml	– notice: 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2018 by the authors. 2018
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Keywords	skin stem cells wound healing stromal vascular fraction adipose derived stromal cells lipografting
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SubjectTerms	Adipocytes adipose derived stromal cells Adipose tissue Amputation Angiogenesis Bioengineering Body fat Clinical trials Cytokines Damage Diabetes Enzymes Extracellular matrix Fibrosis Growth factors Hair Homeostasis Hyperglycemia Inflammation Ischemia lipografting Parenchyma Physiology Regeneration Review Scars Senescence Skin Stem cells Stromal cells stromal vascular fraction Trauma Ulcers Wound healing
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