The role of orthobiologics in chronic wound healing.
bone‐marrow‐derived products
platelet‐derived products
regenerative medicine
stromal vascular fraction
wound healing
Journal
International wound journal
ISSN: 1742-481X
Titre abrégé: Int Wound J
Pays: England
ID NLM: 101230907
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
15
02
2024
accepted:
13
03
2024
medline:
15
4
2024
pubmed:
15
4
2024
entrez:
15
4
2024
Statut:
ppublish
Résumé
Chronic wounds, characterized by prolonged healing processes, pose a significant medical challenge with multifaceted aetiologies, including local and systemic factors. Here, it explores the complex pathogenesis of chronic wounds, emphasizing the disruption in the normal phases of wound healing, particularly the inflammatory phase, leading to an imbalance in extracellular matrix (ECM) dynamics and persistent inflammation. Senescent cell populations further contribute to impaired wound healing in chronic lesions. Traditional medical management focuses on addressing underlying causes, but many chronic wounds resist to conventional treatments, necessitating innovative approaches. Recent attention has turned to autologous orthobiologics, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF) and mesenchymal stem cells (MSCs), as potential regenerative interventions. These biologically derived materials, including bone marrow aspirate/concentrate (BMA/BMAC) and adipose tissue-derived stem cells (ADSCs), exhibit promising cytokine content and regenerative potential. MSCs, in particular, have emerged as key players in wound healing, influencing inflammation and promoting tissue regeneration. This paper reviews relevant scientific literature regarding basic science and brings real-world evidence regarding the use of orthobiologics in the treatment of chronic wounds, irrespective of aetiology. The discussion highlights the regenerative properties of PRP, PRF, BMA, BMAC and SVF, showcasing their potential to enhance wound healing. Despite advancements, further research is essential to elucidate the specific roles of each orthobiologic and determine optimal applications for different wound types. The conclusion underscores the evolving landscape in chronic wound management, with a call for more comprehensive studies to refine treatment strategies and maximize the benefits of regenerative medicine.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14854Informations de copyright
© 2024 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Références
Lazarus GS, Cooper DM, Knighton DR, et al. Definitions and guidelines for assessment of wounds and evaluation of healing. Arch Dermatol. 1994;130(4):489‐493.
Martin P, Nunan R. Cellular and molecular mechanisms of repair in acute and chronic wound healing. Br J Dermatol. 2015;173(2):370‐378. doi:10.1111/bjd.13954
Leaper DJ, Durani P. Topical antimicrobial therapy of chronic wounds healing by secondary intention using iodine products. Int Wound J. 2008;5(2):361‐368. doi:10.1111/j.1742‐481X.2007.00406.x
Schreml S, Szeimies RM, Prantl L, Karrer S, Landthaler M, Babilas P. Oxygen in acute and chronic wound healing. Br J Dermatol. 2010;163(2):257‐268. doi:10.1111/j.1365‐2133.2010.09804.x
Martinez‐Zapata MJ, Martí‐Carvajal AJ, Solà I, et al. Autologous platelet‐rich plasma for treating chronic wounds. Cochrane Database Syst Rev. 2016;2016(5):CD006899. doi:10.1002/14651858.CD006899.pub3
Attinger CE, Janis JE, Steinberg J, Schwartz J, Al‐Attar A, Couch K. Clinical approach to wounds: débridement and wound bed preparation including the use of dressings and wound‐healing adjuvants. Plast Reconstr Surg. 2006;117(7 Suppl):72S‐109S. doi:10.1097/01.prs.0000225470.42514.8f
Gurtner GC, Werner S, Barrandon Y, Longaker MT. Wound repair and regeneration. Nature. 2008;453(7193):314‐321. doi:10.1038/nature07039
Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care. 2015;4(9):560‐582. doi:10.1089/wound.2015.0635
Soneja A, Drews M, Malinski T. Role of nitric oxide, nitroxidative and oxidative stress in wound healing. Pharmacol Rep. 2005;57:108‐119.
Werner S, Grose R. Regulation of wound healing by growth factors and cytokines. Physiol Rev. 2003;83(3):835‐870. doi:10.1152/physrev.2003.83.3.835
Opalenik SR, Davidson JM. Fibroblast differentiation of bone marrow‐derived cells during wound repair. FASEB J. 2005;19(11):1561‐1563. doi:10.1096/fj.04‐2978fje
Falanga V. Wound healing and its impairment in the diabetic foot. Lancet. 2005;366(9498):1736‐1743. doi:10.1016/S0140‐6736(05)67700‐8
Schultz GS, Sibbald RG, Falanga V, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003 Mar;11(Suppl 1):S1‐S28. doi:10.1046/j.1524‐475x.11.s2.1.x
McCarty SM, Percival SL. Proteases and delayed wound healing. Adv Wound Care. 2013;2(8):438‐447. doi:10.1089/wound.2012.0370
Telgenhoff D, Shroot B. Cellular senescence mechanisms in chronic wound healing. Cell Death Differ. 2005;12(7):695‐698. doi:10.1038/sj.cdd.4401632
Rodrigues I, Mégie MF. Prevalence of chronic wounds in Quebec home care: an exploratory study. Ostomy Wound Manage. 2006;52(5):46‐48, 50, 52‐7.
Everts PA, Sadeghi P, Smith DR. Basic science of autologous Orthobiologics: part 1. Platelet‐rich plasma. Phys Med Rehabil Clin N Am. 2023;34(1):1‐23. doi:10.1016/j.pmr.2022.08.003
Lana JFSD, Lana AVSD, da Fonseca LF, et al. Stromal vascular fraction for knee osteoarthritis ‐ An update. J Stem Cells Regen Med. 2022;18(1):11‐20. doi:10.46582/jsrm.1801003
Ennis WJ, Sui A, Bartholomew A. Stem cells and healing: impact on inflammation. Adv Wound Care (New Rochelle). 2013;2(7):369‐378. doi:10.1089/wound.2013.0449
Collins T, Alexander D, Barkatali B. Platelet‐rich plasma: a narrative review. EFORT Open Rev. 2021;6(4):225‐235. doi:10.1302/2058‐5241.6.200017
Everts PA, Knape JT, Weibrich G, et al. Platelet‐rich plasma and platelet gel: a review. J Extra Corpor Technol. 2006;38(2):174‐187.
Iberg CA, Hawiger D. Natural and induced tolerogenic dendritic cells. J Immunol. 2020;204(4):733‐744. doi:10.4049/jimmunol.1901121
Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet‐rich plasma: new performance understandings and therapeutic considerations in 2020. Int J Mol Sci. 2020;21(20):7794. doi:10.3390/ijms21207794
Pakala R, Willerson JT, Benedict CR. Mitogenic effect of serotonin on vascular endothelial cells. Circulation. 1994;90(4):1919‐1926. doi:10.1161/01.cir.90.4.1919
Marx RE. Platelet‐rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10(4):225‐228. doi:10.1097/00008505‐200110000‐00002
Oh JH, Kim W, Park KU, Roh YH. Comparison of the cellular composition and cytokine‐release kinetics of various platelet‐rich plasma preparations. Am J Sports Med. 2015;43(12):3062‐3070. doi:10.1177/0363546515608481
Everts PA, Malanga GA, Paul RV, Rothenberg JB, Stephens N, Mautner KR. Assessing clinical implications and perspectives of the pathophysiological effects of erythrocytes and plasma free hemoglobin in autologous biologics for use in musculoskeletal regenerative medicine therapies. A Review Regen Ther. 2019;11:56‐64. doi:10.1016/j.reth.2019.03.009
Qu S, Hu Z, Zhang Y, et al. Clinical studies on platelet‐rich plasma therapy for chronic cutaneous ulcers: a systematic review and meta‐analysis of randomized controlled trials. Adv Wound Care (New Rochelle). 2022;11(2):56‐69. doi:10.1089/wound.2020.1186
Villela DL, Santos VL. Evidence on the use of platelet‐rich plasma for diabetic ulcer: a systematic review. Growth Factors. 2010;28(2):111‐116. doi:10.3109/08977190903468185
Fang Q, Zhang Y, Tang L, et al. Clinical study of platelet‐rich plasma (PRP) for lower extremity venous ulcers: a meta‐analysis and systematic review. Int J Low Extrem Wounds. 2023;22(4):641‐653. doi:10.1177/15347346211046203
Haddadi P, Khorshidi H, Raoufi S, Nazhvani AD, Badiee P. Comparative evaluation of conventional and Nanosilver‐containing leucocyte and platelet‐rich fibrin/biomaterial in the anti‐biofilm formation of standard species of Candida and Streptococcus. Jundishapur J Microbiol. 2018;11(8):e68423. doi:10.5812/jjm.68423
Dohan Ehrenfest DM, Andia I, Zumstein MA, Zhang CQ, Pinto NR, Bielecki T. Classification of platelet concentrates (platelet‐rich plasma‐PRP, platelet‐rich fibrin‐PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J. 2014;4(1):3‐9.
Lombard T, Neirinckx V, Rogister B, Gilon Y, Wislet S. Medication‐related osteonecrosis of the jaw: new insights into molecular mechanisms and cellular therapeutic approaches. Stem Cells Int. 2016;2016:8768162. doi:10.1155/2016/8768162
Kobayashi E, Flückiger L, Fujioka‐Kobayashi M, et al. Comparative release of growth factors from PRP, PRF, and advanced‐PRF. Clin Oral Investig. 2016;20(9):2353‐2360. doi:10.1007/s00784‐016‐1719‐1
Bielecki T, Dohan Ehrenfest DM, Everts PA, Wiczkowski A. The role of leukocytes from L‐PRP/L‐PRF in wound healing and immune defense: new perspectives. Curr Pharm Biotechnol. 2012;13(7):1153‐1162. doi:10.2174/138920112800624373
Serafini G, Lollobrigida M, Fortunato L, et al. Postextractive alveolar ridge preservation using L‐PRF: clinical and histological evaluation. Case Rep Dent. 2020;2020:5073519. doi:10.1155/2020/5073519
Dohan DM, Choukroun J, Diss A, et al. Platelet‐rich fibrin (PRF): a second‐generation platelet concentrate. Part II: platelet‐related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e45‐e50. doi:10.1016/j.tripleo.2005.07.009
Haidar SZ. L‐PRF: a “super” biomaterial for naturally guided hard/soft tissue bioengineering and regeneration of Oro‐dental, periodontal and jaw defects. Bone grafting – recent advances with special References to Cranio‐maxillofacial surgery. IntechOpen. 2018. doi:10.5772/intechopen.78672
Crisci A, Marotta G, Licito A, Serra E, Benincasa G, Crisci M. Use of leukocyte platelet (L‐PRF) rich fibrin in diabetic foot ulcer with osteomyelitis (three clinical cases report). Diseases. 2018;6(2):30. doi:10.3390/diseases6020030
Pinto NR, Ubilla M, Zamora Y, Del Rio V, Dohan Ehrenfest DM, Quirynen M. Leucocyte‐ and platelet‐rich fibrin (L‐PRF) as a regenerative medicine strategy for the treatment of refractory leg ulcers: a prospective cohort study. Platelets. 2018;29(5):468‐475. doi:10.1080/09537104.2017.1327654
Dorjay K, Sinha S. Platelet‐rich fibrin in nonhealing leg ulcers: a simple and effective therapeutic option. J Cutan Aesthet Surg. 2021;14(2):160‐165. doi:10.4103/JCAS.JCAS_130_19
Somani A, Rai R. Comparison of efficacy of autologous platelet‐rich fibrin versus saline dressing in chronic venous leg ulcers: a randomised controlled trial. J Cutan Aesthet Surg. 2017;10(1):8‐12. doi:10.4103/JCAS.JCAS_137_16
Santos Duarte Lana JF, Furtado da Fonseca L, Mosaner T, et al. Bone marrow aspirate clot: a feasible orthobiologic. J Clin Orthop Trauma. 2020;11(Suppl 5):S789‐S794. doi:10.1016/j.jcot.2020.07.003
Kandarakov O, Belyavsky A, Semenova E. Bone marrow niches of hematopoietic stem and progenitor cells. Int J Mol Sci. 2022;23(8):4462. doi:10.3390/ijms23084462
Mizukami A, Swiech K. Mesenchymal stromal cells: from discovery to manufacturing and commercialization. Stem Cells Int. 2018;2018:4083921. doi:10.1155/2018/4083921
Jo H, Brito S, Kwak BM, Park S, Lee MG, Bin BH. Applications of mesenchymal stem cells in skin regeneration and rejuvenation. Int J Mol Sci. 2021;22(5):2410. doi:10.3390/ijms22052410
Cottom JM, Plemmons BS. Bone marrow aspirate concentrate and its uses in the foot and ankle. Clin Podiatr Med Surg. 2018;35(1):19‐26. doi:10.1016/j.cpm.2017.08.006
Chiossone L, Conte R, Spaggiari GM, et al. Mesenchymal stromal cells induce peculiar alternatively activated macrophages capable of dampening both innate and adaptive immune responses. Stem Cells. 2016;34(7):1909‐1921. doi:10.1002/stem.2369
Ellis S, Lin EJ, Tartar D. Immunology of wound healing. Curr Dermatol Rep. 2018;7(4):350‐358. doi:10.1007/s13671‐018‐0234‐9
Rogers LC, Bevilacqua NJ, Armstrong DG. The use of marrow‐derived stem cells to accelerate healing in chronic wounds. Int Wound J. 2008;5(1):20‐25. doi:10.1111/j.1742‐481X.2007.00349.x
McFarlin K, Gao X, Liu YB, et al. Bone marrow‐derived mesenchymal stromal cells accelerate wound healing in the rat. Wound Repair Regen. 2006;14(4):471‐478. doi:10.1111/j.1743‐6109.2006.00153.x
Cooney DS, Wimmers EG, Ibrahim Z, et al. Mesenchymal stem cells enhance nerve regeneration in a rat sciatic nerve repair and hindlimb transplant model. Sci Rep. 2016;6:31306. doi:10.1038/srep31306
Pierini M, Di Bella C, Dozza B, et al. The posterior iliac crest outperforms the anterior iliac crest when obtaining mesenchymal stem cells from bone marrow. J Bone Joint Surg Am. 2013;95(12):1101‐1107. doi:10.2106/JBJS.L.00429
Kim GB, Seo MS, Park WT, Lee GW. Bone marrow aspirate concentrate: its uses in osteoarthritis. Int J Mol Sci. 2020;21(9):3224. doi:10.3390/ijms21093224
Condé‐Green A, Marano AA, Lee ES, et al. Fat grafting and adipose‐derived regenerative cells in burn wound healing and scarring: a systematic review of the literature. Plast Reconstr Surg. 2016;137(1):302‐312. doi:10.1097/PRS.0000000000001918
Zuk PA, Zhu M, Ashjian P, et al. Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell. 2002;13(12):4279‐4295. doi:10.1091/mbc.e02‐02‐0105
An Y, Lin S, Tan X, et al. Exosomes from adipose‐derived stem cells and application to skin wound healing. Cell Prolif. 2021;54(3):e12993. doi:10.1111/cpr.12993
Fraser JK, Zhu M, Wulur I, Alfonso Z. Adipose‐derived stem cells. Methods Mol Biol. 2008;449:59‐67. doi:10.1007/978‐1‐60327‐169‐1_4
Trottier V, Marceau‐Fortier G, Germain L, Vincent C, Fradette J. IFATS collection: using human adipose‐derived stem/stromal cells for the production of new skin substitutes. Stem Cells. 2008;26(10):2713‐2723. doi:10.1634/stemcells.2008‐0031
Bruno A, Delli Santi G, Fasciani L, Cempanari M, Palombo M, Palombo P. Burn scar lipofilling: immunohistochemical and clinical outcomes. J Craniofac Surg. 2013;24(5):1806‐1814. doi:10.1097/SCS.0b013e3182a148b9
Piccolo NS, Piccolo MS, Piccolo MT. Fat grafting for treatment of burns, burn scars, and other difficult wounds. Clin Plast Surg. 2015;42(2):263‐283. doi:10.1016/j.cps.2014.12.009
Toyserkani NM, Christensen ML, Sheikh SP, Sørensen JA. Adipose‐derived stem cells: new treatment for wound healing? Ann Plast Surg. 2015;75(1):117‐123. doi:10.1097/SAP.0000000000000083
Lana JFSD, Lana AVSD, da Fonseca LF, et al. Stromal vascular fraction for knee osteoarthritis ‐ An update. J Stem Cells Regen Med. 2022;18(1):11‐20. doi:10.46582/jsrm.1801003
Deng C, Wang L, Feng J, Lu F. Treatment of human chronic wounds with autologous extracellular matrix/stromal vascular fraction gel: a STROBE‐compliant study. Medicine (Baltimore). 2018;97(32):e11667. doi:10.1097/MD.0000000000011667
Morris ME, Beare JE, Reed RM, et al. Systemically delivered adipose stromal vascular fraction cells disseminate to peripheral artery walls and reduce vasomotor tone through a CD11b+ cell‐dependent mechanism. Stem Cells Transl Med. 2015;4(4):369‐380.
Rosa I, Romano E, Fioretto BS, Matucci‐Cerinic M, Manetti M. Adipose‐derived stem cells: pathophysiologic implications vs therapeutic potential in systemic sclerosis. World J Stem Cells. 2021;13(1):30‐48. doi:10.4252/wjsc.v13.i1.30
Bora P, Majumdar AS. Adipose tissue‐derived stromal vascular fraction in regenerative medicine: a brief review on biology and translation. Stem Cell Res Ther. 2017;8(1):145. doi:10.1186/s13287‐017‐0598‐y
Aronowitz JA, Lockhart RA, Hakakian CS. Mechanical versus enzymatic isolation of stromal vascular fraction cells from adipose tissue. Springerplus. 2015;4:713. doi:10.1186/s40064‐015‐1509‐2
Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013;132(4):1017‐1026. doi:10.1097/PRS.0b013e31829fe1b0
Frantz C, Stewart KM, Weaver VM. The extracellular matrix at a glance. J Cell Sci. 2010;123(Pt 24):4195‐4200. doi:10.1242/jcs.023820
Zhou ZQ, Chen Y, Chai M, et al. Adipose extracellular matrix promotes skin wound healing by inducing the differentiation of adiposederived stem cells into fibroblasts. Int J Mol Med. 2019;43(2):890‐900. doi:10.3892/ijmm.2018.4006
Hersant B, Sid‐Ahmed M, Braud L, et al. Platelet‐rich plasma improves the wound healing potential of mesenchymal stem cells through paracrine and metabolism alterations. Stem Cells Int. 2019;2019:1234263. doi:10.1155/2019/1234263
Blanton MW, Hadad I, Johnstone BH, et al. Adipose stromal cells and platelet‐rich plasma therapies synergistically increase revascularization during wound healing. Plast Reconstr Surg. 2009;123(2 Suppl):56S‐64S. doi:10.1097/PRS.0b013e318191be2d
Chittoria RK, Nandhagopal V, Mohapatra DP, Thiruvoth FM, Sivakumar DK, Asokan A. Autologous bone marrow aspirate therapy in wound healing. Adv Wound Care (New Rochelle). 2016;5(3):102‐105. doi:10.1089/wound.2014.0612
Gupta GJ, Karki K, Jain P, Saxena AK. Autologous bone marrow aspirate therapy for skin tissue engineering and tissue regeneration. Adv Wound Care (New Rochelle). 2017;6(4):135‐142. doi:10.1089/wound.2016.0704
Mulder G, Lee DK, Faghihnia N. Autologous bone marrow‐derived stem cells for chronic wounds of the lower extremity: a retrospective study. Wounds. 2010;22(9):219‐225.