2022, Vol. 26 ›› Issue (30): 4896-4903

Mechanism and different transplantation approaches of mesenchymal stem cells in repairing chronic wounds

Chen Bei1, Zhang Li2, Liu Yi3, Sang Peng3, Jin Ying3, Lin Miaoyuan1, Xiao Leyao1, Xiong Huazhang3   

Abstract: BACKGROUND: Mesenchymal stem cell transplantation has proven to be a promising new therapy in the treatment of chronic wounds. In terms of enhancing the efficacy, there are few reports on the different delivery routes of mesenchymal stem cells and the comparison of their advantages and disadvantages. Optimizing the delivery route is particularly important for improving the application effect of mesenchymal stem cells in wound repair.
OBJECTIVE: To discuss the relevant mechanisms of mesenchymal stem cells in promoting wound repair, and summarize the application effects of different transplantation methods in chronic wound repair.
METHODS: The first author retrieved the relevant documents included in CNKI Database, Wanfang Database and PubMed database. The Chinese search terms were “mesenchymal stem cells, mechanism, transplantation, pathway, chronic wound, vulnus, regeneration, tissue engineering, skin, ulcer”. The English search terms were “stem cell/stromal cells/progenitor cell/mesenchymal stem cells, mechanism/therapeutic application, transplantation route/delivery/engraftment/injection/infusion/drug administration routes, wound healing/chronic wound/regeneration/tissue engineering/tissue repair/skin ulce”. The retrieval time of the literature was limited to January 2000-July 2021. The literature was initially screened by reading the abstract of the article, and the literature that was not related to the subject of the article was excluded, and the number of articles finally included was 85 for review.
RESULTS AND CONCLUSION: (1) The paracrine function is the main mechanism by which mesenchymal stem cells play the role of wound repair. Mesenchymal stem cells promote angiogenesis by secreting soluble factors and releasing extracellular vesicles, reduce local inflammatory response, regulate the remodeling of extracellular matrix, and rebuild the microenvironment of tissue regeneration. (2) In summary, biomaterial scaffolds are one of the most promising transplantation methods for mesenchymal stem cells. Compared with traditional systemic administration (arterial administration and intravenous administration) and traditional local administration (such as subcutaneous and intramuscular injection), excellent plasticity, bioactivity, biodegradation and biocompatibility are the four key characteristics of their advantages. It overcomes many problems of poor safety and low efficiency of traditional drug delivery routes, which improves the application effect of mesenchymal stem cells in chronic wounds, and its advantages need to be further developed. (3) The choice of transplantation pathway depends on its therapeutic purpose and mechanism to a certain extent. (4) As for the relationship between the action mechanism of mesenchymal stem cells and the route of administration, the homing of mesenchymal stem cells to the damaged tissue was taken as an example. When the transplantation mode of mesenchymal stem cells is local administration (such as intramuscular), in addition to the basic interstitial migration of mesenchymal stem cells in the damaged tissue, the homing and migration of mesenchymal stem cells are not necessary. If the transportation of mesenchymal stem cells is holistic (such as arterial pathway and venous pathway), the homing mechanism of mesenchymal stem cells is necessary to achieve its repair goal. Therefore, to improve the application quality, the route of administration and the mechanism of mesenchymal stem cells participating in wound repair should be considered comprehensively.  
Key words: mesenchymal stem cells, chronic wounds, skin, mechanism, infusion route, transplantation, tissue engineering, regenerative medicine