Theoretical and practical aspects of using fetal fibroblasts for skin regeneration

Wound Tissue Regeneration by Microfluidic Generated Fibroblast Cell/CuO Nanosheet-Loaded Alginate Hydrogel on an Excisional Full-Thickness Rat Model

Chronic ulcers present numerous challenges in treatment such as prolonged inflammation, infections resistant to drugs, and the formation of scars. In this research, we developed a calcium ion (Ca2+) cross-linked alginate (Alg) hydrogel loaded with CuO nanosheet/fibroblast cells via a microfluidic system with substantial efficiency in accelerating healing and preventing infection. Initially, the soft lithography method was utilized to fabricate the microfluidic system, which was employed to produce alginate hydrogel incorporating nanosheets of copper oxide (CuO) and MEF cells. The properties of hydrogel and copper oxide nanosheets were analyzed by using FE-SEM, EDS/EDX, and elemental mapping to determine their physicochemical characteristics. The viability of mouse embryonic fibroblast cells (MEF) in alginate-CuO hydrogel was explored through cell viability assay, and the antibacterial properties were also studied using colony-forming assay. The healing abilities of the hydrogel were investigated using an excisional, full-thickness wound rat model. Our results revealed proper antimicrobial and angiogenic properties with slight cytotoxicity for CuO nanosheets at a concentration of 25 μg/mL. The alginate-CuO-cell-treated group exhibited a faster wound contraction and healing among all treatments. The results of the in vivo assay along with histology and gene expression indicate a synergistic cooperation between MEF and CuO, leading to enhanced re-epithelialization, angiogenesis, and matrix remodeling. In this research, a therapeutic hydrogel with qualities like microbicidal, angiogenic, immune system modulation, and promotion of ECM and epithelium regeneration, resulting in faster healing, was developed. Moreover, there was a synergic impact noticed between CuO nanosheets and MEF cells as well as improved formation of blood vessels and collagen accumulation. In conclusion, this biocompatible hydrogel offers a promising strategy for effective wound healing without the need for invasive procedures.

Epac1 activation optimizes cellular functions of BMSCs and promotes wound healing via Erk/ACLY/PGC-1α signaling pathway

Restrained cell function of relocated bone marrow mesenchymal stem cells (BMSCs) largely impedes the clinical benefits of BMSCs-mediated tissue repair. Exchange protein directly activated by cAMP (Epac), a novel protein discovered in cAMP signaling pathway, has a potential role in regulating cell migration and proliferation by triggering the downstream Rap signaling. However, whether and how Epac may exert effects on BMSCs' bioactivity have less been investigated. Here we showed that Epac1 was predominantly expressed in BMSCs and Epac1 activation by 8-pCPT enhanced BMSCs proliferation. 8-pCPT also altered F-actin cytoskeleton and promoted BMSCs migration. By contrast, Epac1 inhibitor ESI-09 resulted in retarded cell migration in 8-pCPT-treated BMSCs. Epac1 activation was further found to be contributed directly to the chemotactic responses induced by CXCL12. The proteomic analysis revealed that ACLY expression significantly increased and Chemokine signaling pathway was robustly activated in 8-pCPT-treated BMSCs. In addition, 8-pCPT up-regulated the protein levels of active Rap1, p-Erk, p-ACLY, VEGF-A and PGC-1α in BMSCs; however, ESI-09 prevented the increase of p-Erk, VEGF-A and PGC-1α induced by 8-pCPT, but further enhanced the p-ACLY level, which consequently stimulated an apoptosis signal as revealed by increased caspase-3 cleavage. Notably, 8-pCPT promoted VEGF paracrine of BMSCs. Finally, we demonstrated that 8-pCPT-treated BMSCs accelerated the cutaneous wound healing process in a mice wound model, while treatment with ESI-09 obviously inhibited these effects. In conclusion, this study suggests that appropriate manipulation of Epac1 may enhance the therapeutic effects of BMSCs and facilitate their future clinical applications in tissue repair.

A New Strategy to Inhibit Scar Formation by Accelerating Normal Healing Using Silicate Bioactive Materials

Inspired by the scar-free wound healing in infants, an anti-scar strategy is proposed by accelerating wound healing using silicate bioactive materials. Bioglass/alginate composite hydrogels are applied, which significantly inhibit scar formation in rabbit ear scar models. The underlining mechanisms include stimulation of Integrin Subunit Alpha 2 expression in dermal fibroblasts to accelerate wound healing, and induction of apoptosis of hypertrophic scar fibroblasts by directly stimulating the N-Acylsphingosine Amidohydrolase 2 expression in hypertrophic scar fibroblasts, and indirectly upregulating the secretion of Cathepsin K in dermal fibroblasts. Considering specific functions of the bioactive silicate materials, two scar treatment regimes are tested. For severe scars, a regenerative intervention is applied by surgical removal of the scar followed by the treatment with bioactive hydrogels to reduce the formation of scars by activating dermal fibroblasts. For mild scars, the bioactive dressing is applied on the formed scar and reduces scar by inducing scar fibroblasts apoptosis.

Enhancement of Wound Healing and Angiogenesis Using Mouse Embryo Fibroblasts Loaded in Decellularized Skin Scaffold

Background

Synthetic and natural polymer scaffolds can be used to design wound dressing for repairing the damaged skin tissue. This study investigated acute wound healing process using a decellularized skin scaffold and mouse embryo fibroblast (MEF).

Methods

Mouse skin fragments were decellularized and evaluated by DNA content, toxicity, H&E staining, Raman confocal microscopy, Masson’s trichrome staining, SEM, and biodegradation assays. The fragments were recellularized by the MEFs, and cell attachment and penetration were studied. De- and decellularized scaffolds were used wound dressings in mouse acute wound models as two experimental groups. Using morphological and immunohistochemical assessments, wound healing was evaluated and compared among the experimental and control groups.

Results

DNA content of the decellularized tissue significantly reduced compared to the native control group (7% vs. 100%; p < 0.05). extracellular matrix components, e.g. collagen types I, III, and IV, elastin, and glycosaminoglycan, were well preserved in the decellularized group. The porosity and fiber arrangement in the stroma had a structure similar to normal skin tissue. A significant reduction in healing time was observed in the group treated with a decellularized scaffold. A thicker epidermis layer was observed in the recovered tissue in both experimental groups compared to the control group. Immunostaining showed a positive reaction for CD31 as an endothelial marker in both experimental groups, confirming new vascularization in these groups.

Conclusion

Using MEFs with decellularized skin as a wound dressing increases the rate of wound healing and also the formation of new capillaries. This system could be beneficial for clinical applications in the field of tissue engineering.

Engineering Bioactive Scaffolds for Skin Regeneration

Large skin wounds pose a major clinical challenge. Scarcity of donor site and postsurgical scarring contribute to the incomplete or partial loss of function and aesthetic concerns in skin wound patients. Currently, a wide variety of skin grafts are being applied in clinical settings. Scaffolds are used to overcome the issues related to the misaligned architecture of the repaired skin tissues. The current review summarizes the contribution of biomaterials to wound healing and skin regeneration and addresses the existing limitations in skin grafting. Then, the clinically approved biologic and synthetic skin substitutes are extensively reviewed. Next, the techniques for modification of skin grafts aiming for enhanced tissue regeneration are outlined, and a summary of different growth factor delivery systems using biomaterials is presented. Considering the significant progress in biomaterial science and manufacturing technologies, the idea of biomaterial-based skin grafts with the ability for scarless wound healing and reconstructing full skin organ is more achievable than ever.

Three-dimensional bioprinting of a full-thickness functional skin model using acellular dermal matrix and gelatin methacrylamide bioink

Treatment of full-thickness skin defects still presents a significant challenge in clinical practice. Three-dimensional (3D) bioprinting technique offers a promising approach for fabricating skin substitutes. However, it is necessary to identify bioinks that have both sufficient mechanical properties and desirable biocompatibilities. In this study, we successfully fabricated acellular dermal matrix (ADM) and gelatin methacrylamide (GelMA) bioinks. The results demonstrated that ADM preserved the main extracellular matrix (ECM) components of the skin and GelMA had tunable mechanical properties. Both bioinks with shear-thinning properties were suitable for 3D bioprinting and GelMA bioink exhibited high printability. Additionally, the results revealed that 20% GelMA with sufficient mechanical properties was suitable to engineer epidermis, 1.5% ADM and 10% GelMA displayed relatively good cytocompatibilities. Here, we proposed a new 3D structure to simulate natural full-thickness skin, which included 20% GelMA with HaCaTs as an epidermal layer, 1.5% ADM with fibroblasts as the dermis, and 10% GelMA mesh with human umbilical vein endothelial cells (HUVECs) as the vascular network and framework. We demonstrated that this 3D bioprinting functional skin model (FSM) could not only promote cell viability and proliferation, but also support epidermis reconstruction in vitro. When transplanted in vivo, the FSM could maintain cell viability for at least 1 week. Furthermore, the FSM promoted wound healing and re-epithelization, stimulated dermal ECM secretion and angiogenesis, and improved wound healing quality. The FSM may provide viable functional skin substitutes for future clinical applications. STATEMENT OF SIGNIFICANCE: We propose a new 3D structure to simulate natural full-thickness skin, which included 20% GelMA with HaCaTs as an epidermal layer, 1.5% ADM with fibroblasts as the dermis, and 10% GelMA mesh with HUVECs as the vascular network. It could not only maintain a moist microenvironment and barrier function, but also recreate the natural skin microenvironment to promote cell viability and proliferation. This may provide viable functional skin substitutes for future clinical applications.

Scar-Free Healing: Current Concepts and Future Perspectives

Every year, millions of people develop scars due to skin injuries after trauma, surgery, or skin burns. From the beginning of wound healing development, scar hyperplasia, and prolonged healing time in wound healing have been severe problems. Based on the difference between adult and fetal wound healing processes, many promising therapies have been developed to decrease scar formation in skin wounds. Currently, there is no good or reliable therapy to cure or prevent scar formation. This work briefly reviews the engineering methods of scarless wound healing, focusing on regenerative biomaterials and different cytokines, growth factors, and extracellular components in regenerative wound healing to minimize skin damage cell types, and scar formation.

Prospects for the application of growth factors in wound healing

As the largest organ of the body, human skin is multifunctional and enjoys two layers, the epidermis and the dermis, the separation of which is performed by a basement membrane zone. Skin protects the body against mechanical forces and infections. Skin wounds represent large and growing challenges to the healthcare systems globally. Skin wound healing, as a protective shield for the body against the external environment, includes interactions among cell types, the neurovascular system, cytokines, and matrix remodeling. Growth factors (GFs) affect the microenvironment of the wound, and cause rises in cell differentiation, proliferation, and migration. Administrating exogenous GFs has revealed potential in enhancing wound healing outcomes. The use of human GFs in the field of wound healing is becoming gradually more interesting, because of the low-invasive techniques required for their use. Reviewed here are the literatures on the healing of skin wounds with emphasize on the role of GFs and their future prospects, containing profits, and probable long-standing side effects accompanied with their use.

Skin tissue regeneration for burn injury

The skin is the largest organ of the body, which meets the environment most directly. Thus, the skin is vulnerable to various damages, particularly burn injury. Skin wound healing is a serious interaction between cell types, cytokines, mediators, the neurovascular system, and matrix remodeling. Tissue regeneration technology remarkably enhances skin repair via re-epidermalization, epidermal-stromal cell interactions, angiogenesis, and inhabitation of hypertrophic scars and keloids. The success rates of skin healing for burn injuries have significantly increased with the use of various skin substitutes. In this review, we discuss skin replacement with cells, growth factors, scaffolds, or cell-seeded scaffolds for skin tissue reconstruction and also compare the high efficacy and cost-effectiveness of each therapy. We describe the essentials, achievements, and challenges of cell-based therapy in reducing scar formation and improving burn injury treatment.