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Review
. 2019 Jul 30;20(15):3721.
doi: 10.3390/ijms20153721.

Secretome of Adipose Tissue-Derived Stem Cells (ASCs) as a Novel Trend in Chronic Non-Healing Wounds: An Overview of Experimental In Vitro and In Vivo Studies and Methodological Variables

Francesca Lombardi  1 , Paola Palumbo  1 , Francesca Rosaria Augello  1 , Maria Grazia Cifone  1 , Benedetta Cinque  2 , Maurizio Giuliani  3   4
Affiliations
Review

Secretome of Adipose Tissue-Derived Stem Cells (ASCs) as a Novel Trend in Chronic Non-Healing Wounds: An Overview of Experimental In Vitro and In Vivo Studies and Methodological Variables

Francesca Lombardi et al. Int J Mol Sci. .

Abstract

Wound healing is a complex process with a linear development that involves many actors in a multistep timeline commonly divided into four stages: Hemostasis, inflammation, proliferation, and remodeling. Chronic non-healing wounds fail to progress beyond the inflammatory phase, thus precluding the next steps and, ultimately, wound repair. Many intrinsic or extrinsic factors may contribute to such an occurrence, including patient health conditions, age-related diseases, metabolic deficiencies, advanced age, mechanical pressure, and infections. Great interest is being focused on the adipose tissue-derived stem cell's (ASC) paracrine activity for its potential therapeutic impact on chronic non-healing wounds. In this review, we summarize the results of in vitro and in vivo experimental studies on the pro-wound healing effects of ASC-secretome and/or extracellular vesicles (EVs). To define an overall picture of the available literature data, experimental conditions and applied methodologies are described as well as the in vitro and in vivo models chosen in the reported studies. Even if a comparative analysis of the results obtained by the different groups is challenging due to the large variability of experimental conditions, the available findings are undoubtedly encouraging and fully support the use of cell-free therapies for the treatment of chronic non-healing wounds.

Keywords: adipose tissue-derived stem cells; chronic non-healing wounds; experimental models; secretome.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The pathophysiology of healing and non-healing wounds. MMP: matrix metalloproteinase.
Figure 2
Figure 2
Schematic representation of the issues related to the ASC cell-free treatment approaches used in the wound-healing experimental studies (described in the text). Identifying an ideal chronic wound model would help to assess the benefits of cell-free ASC-CM or ASC-EV therapy. ASC: adipose tissue-derived cells; CM: conditioned medium; EV: extracellular vesicle.
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