Thermal conditioning improves quality and speed of keratinocyte sheet production for burn wound treatment.

autograft epidermal skin engineering keratinocytes process development thermal conditioning

Journal

Cytotherapy
ISSN: 1477-2566
Titre abrégé: Cytotherapy
Pays: England
ID NLM: 100895309

Informations de publication

Date de publication:
06 2021
Historique:
received: 05 09 2020
revised: 06 01 2021
accepted: 20 01 2021
pubmed: 10 3 2021
medline: 16 10 2021
entrez: 9 3 2021
Statut: ppublish

Résumé

Cultured patient-specific keratinocyte sheets have been used clinically since the 1970s for the treatment of large severe burns. However, despite significant developments in recent years, successful and sustainable treatment is still a challenge. Reliable, high-quality grafts with faster availability and a flexible time window for transplantation are required to improve clinical outcomes. Keratinocytes are usually grown in vitro at 37°C. Given the large temperature differences in native skin tissue, the aim of the authors' study was to investigate thermal conditioning of keratinocyte sheet production. Therefore, the influence of 31°C, 33°C and 37°C on cell expansion and differentiation in terms of proliferation and sheet formation efficacy was investigated. In addition, the thermal effect on the biological status and thus the quality of the graft was assessed on the basis of the release of wound healing-related biofactors in various stages of graft development. The authors demonstrated that temperature is a decisive factor in the production of human keratinocyte sheets. By using specific temperature ranges, the authors have succeeded in optimizing the individual manufacturing steps. During the cell expansion phase, cultivation at 37°C was most effective. After 6 days of culture at 37°C, three times and six times higher numbers of viable cells were obtained compared with 33°C and 31°C. During the cell differentiation and sheet formation phase, however, the cells benefited from a mildly hypothermic temperature of 33°C. Keratinocytes showed increased differentiation potential and formed better epidermal structures, which led to faster biomechanical sheet stability at day 18. In addition, a cultivation temperature of 33°C resulted in a longer lasting and higher secretion of the investigated immunomodulatory, anti-inflammatory, angiogenic and pro-inflammatory biofactors. These results show that by using specific temperature ranges, it is possible to accelerate the large-scale production of cultivated keratinocyte sheets while at the same time improving quality. Cultivated keratinocyte sheets are available as early as 18 days post-biopsy and at any time for 7 days thereafter, which increases the flexibility of the process for surgeons and patients alike. These findings will help to provide better clinical outcomes, with an increased take rate in severe burn patients.

Sections du résumé

BACKGROUND AIMS
Cultured patient-specific keratinocyte sheets have been used clinically since the 1970s for the treatment of large severe burns. However, despite significant developments in recent years, successful and sustainable treatment is still a challenge. Reliable, high-quality grafts with faster availability and a flexible time window for transplantation are required to improve clinical outcomes.
METHODS
Keratinocytes are usually grown in vitro at 37°C. Given the large temperature differences in native skin tissue, the aim of the authors' study was to investigate thermal conditioning of keratinocyte sheet production. Therefore, the influence of 31°C, 33°C and 37°C on cell expansion and differentiation in terms of proliferation and sheet formation efficacy was investigated. In addition, the thermal effect on the biological status and thus the quality of the graft was assessed on the basis of the release of wound healing-related biofactors in various stages of graft development.
RESULTS
The authors demonstrated that temperature is a decisive factor in the production of human keratinocyte sheets. By using specific temperature ranges, the authors have succeeded in optimizing the individual manufacturing steps. During the cell expansion phase, cultivation at 37°C was most effective. After 6 days of culture at 37°C, three times and six times higher numbers of viable cells were obtained compared with 33°C and 31°C. During the cell differentiation and sheet formation phase, however, the cells benefited from a mildly hypothermic temperature of 33°C. Keratinocytes showed increased differentiation potential and formed better epidermal structures, which led to faster biomechanical sheet stability at day 18. In addition, a cultivation temperature of 33°C resulted in a longer lasting and higher secretion of the investigated immunomodulatory, anti-inflammatory, angiogenic and pro-inflammatory biofactors.
CONCLUSIONS
These results show that by using specific temperature ranges, it is possible to accelerate the large-scale production of cultivated keratinocyte sheets while at the same time improving quality. Cultivated keratinocyte sheets are available as early as 18 days post-biopsy and at any time for 7 days thereafter, which increases the flexibility of the process for surgeons and patients alike. These findings will help to provide better clinical outcomes, with an increased take rate in severe burn patients.

Identifiants

pubmed: 33685808
pii: S1465-3249(21)00031-1
doi: 10.1016/j.jcyt.2021.01.006
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

536-547

Informations de copyright

Copyright © 2021 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.

Auteurs

Laura Frese (L)

Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland; Center for Applied Biotechnology and Molecular Medicine, Zurich, Switzerland; La Colline Research Fellow, La Colline, Sion, Switzerland. Electronic address: laura.frese@uzh.ch.

Salim E Darwiche (SE)

Center for Applied Biotechnology and Molecular Medicine, Zurich, Switzerland; Musculoskeletal Research Unit, VetSuisse Faculty, University of Zurich, Zurich, Switzerland.

Brigitte von Rechenberg (B)

Center for Applied Biotechnology and Molecular Medicine, Zurich, Switzerland; Musculoskeletal Research Unit, VetSuisse Faculty, University of Zurich, Zurich, Switzerland.

Simon P Hoerstrup (SP)

Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland; Center for Applied Biotechnology and Molecular Medicine, Zurich, Switzerland.

Pietro Giovanoli (P)

Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.

Maurizio Calcagni (M)

Center for Applied Biotechnology and Molecular Medicine, Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.

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