Enriched adipose stem cell secretome as an effective therapeutic strategy for in vivo wound repair and angiogenesis

Improving the Wound Healing Process: Pivotal role of Mesenchymal stromal/stem Cells and Immune Cells

Wound healing, a physiological process, involves several different types of cells, from immune cells to non-immune cells, including mesenchymal stromal/stem cells (MSC), and their interactions. Immune cells including macrophages, neutrophils, dendritic cells (DC), innate lymphoid cells (ILC), natural killer (NK) cells, and B and T lymphocytes participate in wound healing by secreting various mediators and interacting with other cells. MSCs, as self-renewing, fast proliferating, and multipotent stromal/stem cells, are found in a wide variety of tissues and critically involved in different phases of wound healing by secreting various molecules that help to improve tissue healing and regeneration. In this review, first, we described the four main phases of wound healing, second, we reviewed the function of MSCs, MSC secretome and immune cells in improving the progress of wound repair (mainly focusing on skin wound healing), third, we explained the immune cells/MSCs interactions in the process of wound healing and regeneration, and finally, we introduce clinical applications of MSCs to improve the process of wound healing.

The Hidden Power of the Secretome: Therapeutic Potential on Wound Healing and Cell-Free Regenerative Medicine-A Systematic Review

Various types of wounds represent a persistent healthcare burden that demands innovative and effective therapeutic solutions. Innovative approaches have emerged that focus on skin regeneration with minimal side effects. One such method is cell-free therapy that utilizes the secretome of human mesenchymal stem cells (hMSCs) as a promising alternative to traditional cell-based therapies, leveraging a complex mixture of bioactive molecules, including growth factors, cytokines, and extracellular vesicles, to accelerate tissue regeneration. This systematic review synthesizes the findings of 35 studies evaluating the impact of hMSC-derived secretomes on wound healing, with a focus on their regenerative, immunomodulatory, and angiogenic effects. The influence of MSC sources (adipose tissue, bone marrow, umbilical cord) and culture conditions on secretome composition and efficacy in the cutaneous wound healing process is examined, highlighting their therapeutic potential in regenerative medicine. This review also explores emerging preclinical and clinical applications, highlighting promising results, such as enhanced fibroblast proliferation, reduced inflammation, and improved extracellular matrix remodeling. In addition, advances in secretome-based biomaterials, including hydrogels and scaffolds, which optimize therapeutic delivery and efficacy are discussed. Despite the growing body of evidence supporting the safety and efficacy of secretomes, challenges remain regarding standardization, large-scale production, and clinical validation. This review highlights the potential of MSC-derived secretomes as a next-generation cell-free approach for wound healing and regenerative medicine.

Tissue integrity and healing response in hypoestrogenic animal model treated by mesh implantation with addition of mesenchymal stem cell secretome

Background

Pelvic organ prolapse increases in prevalence and incidence in older women and hypoestrogenic conditions. Treatment with native tissue surgery has a fairly high recurrence rate. Mesh-augmented surgery is one of the most promising treatments for pelvic organ prolapse, with high effectiveness and low recurrence. Mesh-augmented surgery has a side effect of tissue erosion. The addition of secretome is expected to improve tissue integrity and reduce tissue erosion.

Aim

This study aimed to investigate the effect of adding the umbilical cord mesenchymal stem cell (UC-MSC) secretome on preventing tissue inflammatory responses, improving tissue integrity, and accelerating wound healing.

Methods

A total of 32 female New Zealand white rabbit hypoestrogenic models were divided into two groups: the control group with normal mesh and the secretome group with artificial mesh. Hypoestrogenic models were created using the bilateral ovariectomy method. Mesh implantation was performed using a surgical method on hypoestrogenic rabbits. The animals were euthanized on days 7, 14, 28, and 90 after mesh implantation. Histopathology parameters included angiogenesis formation, fibroblast number, and collagen deposition area.

Result

The results of this study showed that the number of angiogenesis, fibroblast, and collagen deposition data in the secretome group showed higher significantly (p < 0.05) than those in the control group on days 7, 14, 28, and 90 post mesh implantation. The formation of new blood vessels (angiogenesis) in the secretome group demonstrated a mean value of 9.81 ± 2.2 compared to 0.37 ± 0.03 in the control. The number of fibroblasts in the secretome group averaged 151.00 ± 8.14, in contrast to 34.00 ± 13.37 in the control group. Collagen formation in the secretome group was also higher, with a mean value of 80.02 ± 6.71 compared to 59.49 ± 4.61 in the control group over 90 days of observation.

Conclusion

The administration of secretomes from UC-MSC improved tissue integrity and accelerated wound healing.

The paradigm of stem cell secretome in tissue repair and regeneration: Present and future perspectives

As the number of patients requiring organ transplants continues to rise exponentially, there is a dire need for therapeutics, with repair and regenerative properties, to assist in alleviating this medical crisis. Over the past decade, there has been a shift from conventional stem cell treatments towards the use of the secretome, the protein and factor secretions from cells. These components may possess novel druggable targets and hold the key to profoundly altering the field of regenerative medicine. Despite the progress in this field, clinical translation of secretome-containing products is limited by several challenges including but not limited to ensuring batch-to-batch consistency, the prevention of further heterogeneity, production of sufficient secretome quantities, product registration, good manufacturing practice protocols and the pharmacokinetic/pharmacodynamic profiles of all the components. Despite this, the secretome may hold the key to unlocking the regenerative blockage scientists have encountered for years. This review critically analyses the secretome derived from different cell sources and used in several tissues for tissue regeneration. Furthermore, it provides an overview of the current delivery strategies and the future perspectives for the secretome as a potential therapeutic. The success and possible shortcomings of the secretome are evaluated.

Tissue integrity and healing response in hypoestrogenic animal model treated by mesh implantation with addition of mesenchymal stem cell secretome

Background

Pelvic organ prolapse increases in prevalence and incidence in older women and hypoestrogenic conditions. Treatment with native tissue surgery has a fairly high recurrence rate. Mesh-augmented surgery is one of the most promising treatments for pelvic organ prolapse, with high effectiveness and low recurrence. Mesh-augmented surgery has a side effect of tissue erosion. The addition of secretome is expected to improve tissue integrity and reduce tissue erosion.

Aim

This study aimed to investigate the effect of adding the umbilical cord mesenchymal stem cell (UC-MSC) secretome on preventing tissue inflammatory responses, improving tissue integrity, and accelerating wound healing.

Methods

A total of 32 female New Zealand white rabbit hypoestrogenic models were divided into two groups: the control group with normal mesh and the secretome group with artificial mesh. Hypoestrogenic models were created using the bilateral ovariectomy method. Mesh implantation was performed using a surgical method on hypoestrogenic rabbits. The animals were euthanized on days 7, 14, 28, and 90 after mesh implantation. Histopathology parameters included angiogenesis formation, fibroblast number, and collagen deposition area.

Result

The results of this study showed that the number of angiogenesis, fibroblast, and collagen deposition data in the secretome group showed higher significantly (p < 0.05) than those in the control group on days 7, 14, 28, and 90 post mesh implantation. The formation of new blood vessels (angiogenesis) in the secretome group demonstrated a mean value of 9.81 ± 2.2 compared to 0.37 ± 0.03 in the control. The number of fibroblasts in the secretome group averaged 151.00 ± 8.14, in contrast to 34.00 ± 13.37 in the control group. Collagen formation in the secretome group was also higher, with a mean value of 80.02 ± 6.71 compared to 59.49 ± 4.61 in the control group over 90 days of observation.

Conclusion

The administration of secretomes from UC-MSC improved tissue integrity and accelerated wound healing.

Topical hADSCs-HA Gel Promotes Skin Regeneration and Angiogenesis in Pressure Ulcers by Paracrine Activating PPARβ/δ Pathway

Background

Pressure ulcer is common in the bedridden elderly with high mortality and lack of effective treatment. In this study, human-adipose-derived-stem-cells-hyaluronic acid gel (hADSCs-HA gel) was developed and applied topically to treat pressure ulcers, of which efficacy and paracrine mechanisms were investigated through in vivo and in vitro experiments.

Methods

Pressure ulcers were established on the backs of C57BL/6 mice and treated topically with hADSCs-HA gel, hADSCs, hyaluronic acid, and normal saline respectively. The rate of wound closure was observed continuously during the following 14 days and the wound samples were obtained for Western blot, histopathology, immunohistochemistry, and proteomic analysis. Human dermal fibroblasts (HDFs) and human venous endothelial cells (HUVECs) under normal or hypoxic conditions were treated with conditioned medium of human ADSCs (ADSC-CM), then CCK-8, scratch test, tube formation, and Western blot were conducted to evaluate the paracrine effects of hADSCs and to explore the underlying mechanism.

Results

The in vivo data demonstrated that hADSCs-HA gel significantly accelerated the healing of pressure ulcers by enhancing collagen expression, angiogenesis, and skin proliferation. The in vitro data revealed that hADSCs strengthened the proliferation and wound healing capabilities of HDFs and HUVECs, meanwhile promoted collagen secretion and tube formation through paracrine mode. ADSC-CM was also proved to exert protective effects on hypoxic HDFs and HUVECs. Besides, the results of proteomic analysis and Western blot elucidated that lipid metabolism and PPARβ/δ pathway mediated the healing effect of hADSCs-HA gel on pressure ulcers.

Conclusion

Our research showed that topical application of hADSCs-HA gel played an important role in dermal regeneration and angiogenesis. Therefore, hADSCs-HA gel exhibited the potential as a novel stem-cell-based therapeutic strategy of treating pressure ulcers in clinical practices.

Multifunctional hydrogel bioscaffolds based on polysaccharide to promote wound healing: A review

Various types of skin wounds pose challenges in terms of healing and susceptibility to infection, which can have a significant impact on physical and mental well-being, and in severe cases, may result in amputation. Conventional wound dressings often fail to provide optimal support for these wounds, thereby impeding the healing process. As a result, there has been considerable interest in the development of multifunctional polymer matrix hydrogel scaffolds for wound healing. This review offers a comprehensive review of the characteristics of polysaccharide-based hydrogel scaffolds, as well as their applications in different types of wounds. Additionally, it evaluates the advantages and disadvantages associated with various types of multifunctional polymer and polysaccharide-based hydrogel scaffolds. The objective is to provide a theoretical foundation for the utilization of multifunctional hydrogel scaffolds in promoting wound healing.