Combination therapy of autologous adipose mesenchymal stem cell-enriched, high-density lipoaspirate and topical timolol for healing chronic wounds
| Autor: | Catherine N. Tchanque-Fossuo, Larissa N Larsen, Sara E. Dahle, Farzam Gorouhi, Chuong Nguyen, Thomas Whetzel, Roslyn Rivkah Isseroff, J. Fuentes, David Boudreault, Robert W. Crawford |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Combination therapy business.industry Mesenchymal stem cell Biomedical Engineering Medicine (miscellaneous) Timolol Adipose tissue medicine.disease Venous leg ulcer Venous stasis Surgery Biomaterials Transplantation 030207 dermatology & venereal diseases 03 medical and health sciences 030104 developmental biology 0302 clinical medicine medicine business Wound healing medicine.drug |
| Zdroj: | Journal of Tissue Engineering and Regenerative Medicine. 12:186-190 |
| ISSN: | 1932-6254 |
| DOI: | 10.1002/term.2390 |
| Popis: | Chronic venous leg ulcers are profoundly debilitating and result in billions in health care expenditure. Thus, there is a quest for engineered and innovative approaches. Herein we present a 63-year-old patient with a 30 year history of venous stasis and left lower extremity ulcers, which have been refractory to standard of care, anticoagulation and venous stripping. The medial ulcer was treated with transplantation of autologous adipose mesenchymal stem cell (AMSC)-enriched, high-density lipoaspirate (HDL) on OASIS wound matrix and compression therapy. The lateral ulcer was treated as a control with standard debridement and compression therapy. Four weeks later, both ulcers received daily topical timolol. Three months later, the test ulcer was completely epithelized and remains healed for over 15 months. However, the control showed minimal signs of improvement. In companion studies in our laboratory, human AMSC were cultured in Minimum Essential Medium Eagle Alpha Modifications (MEMα) with fetal bovine serum (FBS). Timolol was administered to AMSC prior to treatment with epinephrine and 104 bacteria/ml heat-killed Staphylococcus aureus. The MEMα with FBS devoid of AMSC served as a background control. After 24 h, cell culture supernatants and protein lysates were collected to determine cytokine production. There was a statistical significant decrease in pro-inflammatory interleukin-6 and -8 induced by the bacteria (to model the wound environment) in AMSC in the presence of timolol compared with control (p < 0.5). This is the first case of a successful combination of autologous AMSC-enriched, HDL with topical timolol for the healing of chronic venous leg ulcers. Copyright © 2016 John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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