2023, Vol. 27 ›› Issue (1): 152-159

Potential of mesenchymal stem cell preconditioning strategies in the treatment of severe burn injury

Lou Hanxiao, Liu Wenjun, Liu Jun, Wang Xin, Zhang Gaofei, Wang Di, Li Jiamei   

Abstract: BACKGROUND: Mesenchymal stem cells are ideal candidates in regenerative medicine, and their clinical application is currently limited by reduced cell viability and poor paracrine capacity caused by changes in the transplanted microenvironment. The preconditioning strategy is believed to maximize the survival rate and biological role of mesenchymal stem cells in the transplanted microenvironment, providing new ideas and potential for the treatment of severe burn injuries.
OBJECTIVE: To review the potential of mesenchymal stem cell preconditioning strategies in the treatment of severe burn injuries.
METHODS: With “mesenchymal stem cells, MSCs, preconditioning, pretreatment, burn injury, severe burn injury, burn pathophysiology” as the search terms in Chinese and English, the original articles and reviews collected from January 2000 to January 2022 in CNKI database and PubMed database were searched, and screened and analyzed. Finally, 81 articles were selected for review after excluding researches that were not related to this publication, inconsistent, outdated and repetitive, and those with low credibility and poor logical rigor.
RESULTS AND CONCLUSION: (1) The traditional treatment methods after severe burn injury are fluid resuscitation, airway management, infection prevention and control, organ support, early eschar decompression and eschar autograft and allograft transplantation. Clinical treatment still faces great challenges. (2) Mesenchymal stem cells have become a hot spot for treatment because of their low immunogenicity, easy access, and strong tissue repair ability. (3) Once mesenchymal stem cells are applied to burn wounds, they will face the oxidative stress environment caused by ischemia/hypoxia and increased production of reactive oxygen species, resulting in decreased cell survival rate and biological activity. (4) Strategies such as cytokine preconditioning, hypoxia preconditioning, gene modification and drug preconditioning can play a role in treating wound infection, reducing excessive inflammation, relieving hypermetabolic state, regulating immune system, promoting wound healing, and inhibiting therapeutic potential of hypertrophic scars. (5) The application of pretreatment strategies in the clinical treatment of severe burn injuries is limited due to the small number of patients with severe burns and insufficient clinical data to support them. (6) The efficacy and safety of preconditioning strategies in the treatment of severe burn injuries need to be determined through a large number of preclinical studies and clinical cases.
Key words: stem cell, mesenchymal stem cell, paracrine, severe burn injury, burn pathophysiology