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. 2018 Nov 14;9(4):65.
doi: 10.3390/jfb9040065.

Mesenchymal Stem Cells and Transforming Growth Factor-β₃ (TGF-β₃) to Enhance the Regenerative Ability of an Albumin Scaffold in Full Thickness Wound Healing

Dale S Feldman  1 , John F McCauley  2
Affiliations

Mesenchymal Stem Cells and Transforming Growth Factor-β₃ (TGF-β₃) to Enhance the Regenerative Ability of an Albumin Scaffold in Full Thickness Wound Healing

Dale S Feldman et al. J Funct Biomater. .

Abstract

Pressure ulcers are one of the most common forms of skin injury, particularly in the spinal cord injured (SCI). Pressure ulcers are difficult to heal in this population requiring at least six months of bed rest. Surgical treatment (grafting) is the fastest recovery time, but it still requires six weeks of bed rest plus significant additional costs and a high recurrence rate. A significant clinical benefit would be obtained by speeding the healing rate of a non-surgical treatment to close to that of surgical treatment (approximately doubling of healing rate). Current non-surgical treatment is mostly inactive wound coverings. The goal of this project was to look at the feasibility of doubling the healing rate of a full-thickness defect using combinations of three treatments, for the first time, each shown to increase healing rate: application of transforming growth factor-β₃ (TGF-β₃), an albumin based scaffold, and mesenchymal stem cells (MSCs). At one week following surgery, the combined treatment showed the greatest increase in healing rate, particularly for the epithelialization rate. Although the target level of a 100% increase in healing rate over the control was not quite achieved, it is anticipated that the goal would be met with further optimization of the treatment.

Keywords: TGF-β3; albumin scaffold; mesenchymal stem cells; pressure ulcers; wound healing.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Full-thickness wound (A) adding the albumin scaffold (B) after scaffold crosslinking.
Figure 2
Figure 2
(A) A histology slide of the entire wound surrounded by the original skin; (B) Part of the same image with critical areas labeled. Area 1 and 3 are under the new epithelium (NE) and would be the outer part of the wound. The areas in the wound center (areas 2 and 4) would be considered the middle of the wound.
Figure 3
Figure 3
Imaging of mesenchymal stem cells (MSCs) transplanted in the wounds. Shown is a representative fluorescence microscopy image of MSCs (green) after three weeks in vivo.
Figure 4
Figure 4
Epithelialization rates at 1 week following surgery. ** indicates statistical significance between treatment and control. * indicates statistical significance between two treatments (p < 0.05).
Figure 5
Figure 5
Epithelialization rates two weeks following surgery. ** indicates statistical significance between treatment and control. * indicates statistical significance between two treatments (p < 0.05).
Figure 6
Figure 6
Healing rates one week following surgery. ** indicates statistical significance between treatment and control. * indicates statistical significance between two treatments (p < 0.05).
Figure 7
Figure 7
Healing rates two weeks post-surgery. ** indicates statistical significance between treatment and control (p < 0.05).
Figure 8
Figure 8
Epithelialization rate/contraction rate (ER/CR) ratios one week following surgery. ** indicates statistical significance between treatment and control (p < 0.05).
Figure 9
Figure 9
Inner fluorescent cell volume fraction one week following surgery. * indicates statistical significance between two treatments, and ** indicates a significant difference with all other treatments (p < 0.05).
Figure 10
Figure 10
Inner fluorescent cell volume fraction two weeks following surgery. * indicates statistical significance between two treatments, and ** indicates a significant difference with all other treatments (p < 0.05).
Figure 11
Figure 11
Outer fluorescent cell volume fraction two weeks following surgery. * indicates statistical significance between two treatments (p < 0.05).
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