Mesenchymal Stem Cells (MSCs) Therapy for Pressure Ulcers: A Literature Review

Main Article Content

Rudi Margono
Ahmad Fawzy
R. Alif Kuncorojati
Mochammad Haikal Alhamdi

Abstract

Pressure ulcers or injuries, arise from ischemic damage to soft tissues induced by unrelieved pressure over a bony prominence. They are usually difficult to treat with standard medical therapy and often they recur. Promising alternative methods for treatment are now developing in the search for better treatment choices. Within the field of regenerative medicine, ongoing research on advanced therapies seeks to treat pressure ulcers with mesenchymal stem cells (MSCs). This review was synthesized and obtained from various online databases. Scientific articles were selected based on the inclusion criteria. MSCs have anti-inflammatory capabilities, they are very helpful for treating chronic wounds such as pressure ulcers because they can restart healing infected wounds by moving the wound through a chronic inflammatory state and into the subsequent stage of healing. The research indicates that MSCs produce soluble compounds that promote the proliferative and migratory behavior of the dominant cell types in the wound. MSCs promote wound closure with promoting angiogenesis, granulation tissue production, and faster epithelialization. Additionally, it was discovered that the cells create bioactive chemicals that appear to accelerate the regeneration process. These findings show that MSC therapy affects all stages of wound healing, including inflammation, epithelialization, development of granulation tissue, and tissue remodeling. Although there are many medications to treat pressure ulcers, there are surprisingly new therapies that take use of MSCs' positive benefits and crucial for wounds that are difficult to heal.

Article Details

How to Cite
Margono, R., Fawzy, A. ., Kuncorojati, R. A. ., & Alhamdi, M. H. (2023). Mesenchymal Stem Cells (MSCs) Therapy for Pressure Ulcers: A Literature Review. International Journal of Medical Science and Clinical Research Studies, 3(07), 1447–1453. https://doi.org/10.47191/ijmscrs/v3-i7-39
Section
Articles

References

I. Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised national pressure ulcer advisory panel pressure injury staging system: revised pressure injury staging system. Journal of Wound, Ostomy, and Continence Nursing. 2016 Nov;43(6):585.

II. Peirce SM, Skalak TC, Rodeheaver GT. Ischemia‐reperfusion injury in chronic pressure ulcer formation: a skin model in the rat. Wound repair and regeneration. 2000 Jan;8(1):68-76.

III. Anthony D, Alosoumi D, Safari R. Prevalence of pressure ulcers in long-term care: a global review. Journal of wound care. 2019 Nov 2;28(11):702-9.

IV. Sellheyer K, Krahl D. Mesenchymale Stammzellen der Haut. Der Hautarzt. 2010 May;61(5):429-34.

V. Paquet-Fifield S, Schlüter H, Li A, Aitken T, Gangatirkar P, Blashki D, Koelmeyer R, Pouliot N, Palatsides M, Ellis S, Brouard N. A role for pericytes as microenvironmental regulators of human skin tissue regeneration. The Journal of clinical investigation. 2009 Sep 1;119(9):2795-806.

VI. Chen B, Sun Y, Zhang J, Zhu Q, Yang Y, Niu X, Deng Z, Li Q, Wang Y. Human embryonic stem cell-derived exosomes promote pressure ulcer healing in aged mice by rejuvenating senescent endothelial cells. Stem Cell Research & Therapy. 2019 Dec;10:1-7.

VII. Feldman DS, McCauley JF. Mesenchymal stem cells and transforming growth factor-β3 (TGF-β3) to enhance the regenerative ability of an albumin scaffold in full thickness wound healing. Journal of Functional Biomaterials. 2018 Nov 14;9(4):65.

VIII. Lanci A, Merlo B, Mariella J, Castagnetti C, Iacono E. Heterologous Wharton's jelly derived mesenchymal stem cells application on a large chronic skin wound in a 6-month-old filly. Frontiers in Veterinary Science. 2019 Jan 30;6:9.

IX. Iacono E, Lanci A, Merlo B, Ricci F, Pirrone A, Antonelli C, Mariella J, Castagnetti C. Effects of amniotic fluid mesenchymal stem cells in carboxymethyl cellulosegel on healing of spontaneous pressure sores: clinical outcome in sevenhospitalized neonatal foals. Turkish Journal of Biology. 2016;40(2):484-92.

X. Dulamea AO, Sirbu-Boeti MP, Bleotu C, Dragu D, Moldovan L, Lupescu I, Comi G. Autologous mesenchymal stem cells applied on the pressure ulcers had produced a surprising outcome in a severe case of neuromyelitis optica. Neural regeneration research. 2015 Nov;10(11):1841.

XI. Motegi SI, Sekiguchi A, Uchiyama A, Uehara A, Fujiwara C, Yamazaki S, Perera B, Nakamura H, Ogino S, Yokoyama Y, Akai R. Protective effect of mesenchymal stem cells on the pressure ulcer formation by the regulation of oxidative and endoplasmic reticulum stress. Scientific Reports. 2017 Dec 7;7(1):17186.

XII. Yoon D, Yoon D, Sim H, Hwang I, Lee JS, Chun W. Accelerated wound healing by fibroblasts differentiated from human embryonic stem cell-derived mesenchymal stem cells in a pressure ulcer animal model. Stem cells international. 2018 Dec 30;2018.

XIII. Levine JM. Historical perspective on pressure ulcers: the decubitus ominosus of Jean‐Martin Charcot. Journal of the American Geriatrics Society. 2005 Jul;53(7):1248-51.

XIV. Anders J, Heinemann A, Leffmann C, Leutenegger M, Pröfener F, von Renteln-Kruse W. Decubitus ulcers: pathophysiology and primary prevention. Deutsches Ärzteblatt International. 2010 May;107(21):371.

XV. Bansal C, Scott R, Stewart D, Cockerell CJ. Decubitus ulcers: a review of the literature. International journal of dermatology. 2005 Oct;44(10):805-10.

XVI. Van Marum RJ, Meijer JH, Ribbe MW. The relationship between pressure ulcers and skin blood flow response after a local cold provocation. Archives of physical medicine and rehabilitation. 2002 Jan 1;83(1):40-3.

XVII. Leblebici B, Turhan N, Adam M, Akman MN. Clinical and epidemiologic evaluation of pressure ulcers in patients at a university hospital in Turkey. Journal of Wound Ostomy & Continence Nursing. 2007 Jul 1;34(4):407-11.

XVIII. Gefen A. Reswick and Rogers pressure-time curve for pressure ulcer risk. Part 1. Nursing Standard (Through 2013). 2009 Jul 15;23(45):64.

XIX. Qaseem A, Humphrey LL, Forciea MA, Starkey M, Denberg TD, Clinical Guidelines Committee of the American College of Physicians*. Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Annals of internal medicine. 2015 Mar 3;162(5):370-9.

XX. Teasell R, Dittmer DK. Complications of immobilization and bed rest. Part 2: Other complications. Canadian Family Physician. 1993 Jun;39:1440.

XXI. Pressure ulcer treatment. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Guide Clin. 1994 Dec;(15):1-25

XXII. Qaseem A, Humphrey LL, Forciea MA, Starkey M, Denberg TD, Clinical Guidelines Committee of the American College of Physicians*. Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Annals of internal medicine. 2015 Mar 3;162(5):370-9.

XXIII. Aggarwal S, Pittenger MF. Human mesenchymal stem cells modulate allogeneic immune cell responses. Blood. 2005 Feb 15;105(4):1815-22.

XXIV. Gnecchi M, Zhang Z, Ni A, Dzau VJ. Paracrine mechanisms in adult stem cell signaling and therapy. Circulation research. 2008 Nov 21;103(11):1204-19.

XXV. Chen L, Tredget EE, Wu PY, Wu Y. Paracrine factors of mesenchymal stem cells recruit macrophages and endothelial lineage cells and enhance wound healing. PloS one. 2008 Apr 2;3(4):e1886.

XXVI. Hocking AM, Gibran NS. Mesenchymal stem cells: paracrine signaling and differentiation during cutaneous wound repair. Experimental cell research. 2010 Aug 15;316(14):2213-9.

XXVII. Gurtner GC, Werner S, Barrandon Y, Longaker MT. Wound repair and regeneration. Nature. 2008 May 15;453(7193):314-21.

XXVIII. Smith AN, Willis E, Chan VT, Muffley LA, Isik FF, Gibran NS, Hocking AM. Mesenchymal stem cells induce dermal fibroblast responses to injury. Experimental cell research. 2010 Jan 1;316(1):48-54.

XXIX. Ono I, Yamashita T, Hida T, Jin HY, Ito Y, Hamada H, Akasaka Y, Ishii T, Jimbow K. Combined administration of basic fibroblast growth factor protein and the hepatocyte growth factor gene enhances the regeneration of dermis in acute incisional wounds. Wound repair and regeneration. 2004 Jan;12(1):67-79.

XXX. Shah M, Foreman DM, Ferguson MW. Neutralisation of TGF-beta 1 and TGF-beta 2 or exogenous addition of TGF-beta 3 to cutaneous rat wounds reduces scarring. Journal of cell science. 1995 Mar 1;108(3):985-1002.

XXXI. Colwell AS, Beanes SR, Soo C, Dang C, Ting K, Longaker MT, Atkinson JB, Lorenz HP. Increased angiogenesis and expression of vascular endothelial growth factor during scarless repair. Plastic and reconstructive surgery. 2005 Jan 1;115(1):204-12.

XXXII. Nakagawa H, Akita S, Fukui M, Fujii T, Akino K. Human mesenchymal stem cells successfully improve skin‐substitute wound healing. British Journal of Dermatology. 2005 Jul 1;153(1):29-36.

XXXIII. Shumakov VI, Onishchenko NA, Rasulov MF, Krasheninnikov ME, Zaidenov VA. Mesenchymal bone marrow stem cells more effectively stimulate regeneration of deep burn wounds than embryonic fibroblasts. Bulletin of experimental biology and medicine. 2003 Aug;136:192-5.

XXXIV. Badiavas EV, Falanga V. Treatment of chronic wounds with bone marrow–derived cells. Archives of dermatology. 2003 Apr 1;139(4):510-6.

XXXV. Vojtaššák J, Danišovič L, Kubeš M, Bakoš D, Jarabek L, Uličná M, Blaško M. Autologous biograft and mesenchymal stem cells in treatment of the diabetic foot. Neuroendocrinology Letters. 2006 Dec;27(supplement 2):134-7.

XXXVI. Falanga V, Iwamoto S, Chartier M, Yufit T, Butmarc J, Kouttab N, Shrayer D, Carson P. Autologous bone marrow–derived cultured mesenchymal stem cells delivered in a fibrin spray accelerate healing in murine and human cutaneous wounds. Tissue engineering. 2007 Jun

;13(6):1299-312.

XXXVII. Yoshikawa T, Mitsuno H, Nonaka I, Sen Y, Kawanishi K, Inada Y, Takakura Y, Okuchi K, Nonomura A. Wound therapy by marrow mesenchymal cell transplantation. Plastic and reconstructive surgery. 2008 Mar 1;121(3):860-77.

XXXVIII. Dash NR, Dash SN, Routray P, Mohapatra S, Mohapatra PC. Targeting nonhealing ulcers of lower extremity in human through autologous bone marrow-derived mesenchymal stem cells. Rejuvenation research. 2009 Oct 1;12(5):359-66.

XXXIX. Lu D, Chen B, Liang Z, Deng W, Jiang Y, Li S, Xu J, Wu Q, Zhang Z, Xie B, Chen S. Comparison of bone marrow mesenchymal stem cells with bone marrow-derived mononuclear cells for treatment of diabetic critical limb ischemia and foot ulcer: a double-blind, randomized, controlled trial. Diabetes research and clinical practice. 2011 Apr 1;92(1):26-36.

Most read articles by the same author(s)

1 2 3 > >>