Clinical translational potential in skin wound regeneration for adipose-derived, blood-derived, and cellulose materials: cells, exosomes, and hydrogels

Authors: FRAZIER, TRIVIA - Obatala Sciences Inc; ALARCON, ANDREA - Lacell Llc; WU, XIYING - Obatala Sciences Inc; MOHIUDDIN, OMAIR - Karachi University; MOTHERWELL, JESSICA - Walter Reed Army Medical Center; CARLSSON, ANDERS - United States Army Institute Of Surgical Research; CHRISTY, ROBERT - United States Army Institute Of Surgical Research; Edwards, Judson - Vince; Mackin, Robert; Prevost, Nicolette; GLOSTER, ELENA - Xavier University; ZHANG, QIANG - Xavier University; WANG, GUANGDI - Xavier University; HAYES, DAN - Pennsylvania State University; GIMBLE, JEFFREY - Obatala Sciences Inc

Submitted to: Biomolecules EISSN 2218-273X
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/24/2020
Publication Date: 9/27/2020
Citation: Frazier, T., Alarcon, A., Wu, X., Mohiuddin, O., Motherwell, J., Carlsson, A., Christy, R.J., Edwards, J.V., Mackin, R.T., Prevost, N.T., Gloster, E., Zhang, Q., Wang, G., Hayes, D., Gimble, J.M. 2020. Clinical translational potential in skin wound regeneration for adipose-derived, blood-derived, and cellulose materials: cells, exosomes, and hydrogels. Biomolecules EISSN 2218-273X. 10:1373. https://doi.org/10.3390/biom10101373.
DOI: https://doi.org/10.3390/biom10101373

Interpretive Summary: The skin as an organ is uniquely exposed to the environment and is responsible for maintaining the integrity of the body’s fluid dynamics and immune system. Thus, any breach through the skin’s barrier has the potential for severe morbidity and mortality consequences. In the U.S., nearly 2.5 million individuals experience burns annually and of these, 30,000 will be severe enough to require hospitalization in a burn unit specialty treatment center. Similarly, it is estimated that over 10% of U.S. nursing home residents over the age of 70 will experience a pressure ulcer or pressure injury annually. Between 2 to 4% of the health care economy of most advanced industrialized countries is expended in the treatment of pressure injury and its complications. Skin wounds can be infected by bacterial or fungal contaminants leading to patient outcomes complicated by acute and recurrent bacteremia, impaired wound repair, osteomyelitis, sepsis, and death. There have been advancements in the understanding of the biochemical pathways and mechanisms underlying skin regenerative therapies leading to explorations into the use of cells and cell-derived cytokines and exosomes as well as hydrogels. Thus, an opportunity remains to develop alternative approaches and products to accelerate and enhance skin wound regeneration. This paper explores the current direction of product and research approaches with an emphasis on the application of various forms of cellulose for wound healing and tissue engineering.

Technical Abstract: Acute and chronic skin wounds due to burns, pressure injuries, and trauma represent a substantial challenge to health care delivery with particular impact on geriatric and paraplegic/quadriplegic demographics world-wide. Nevertheless, current standard of care relies extensively on preventive measures to mitigate pressure injury, surgical debridement, skin flap procedures, and negative pressure wound vacuum measures. This article highlights the potential of adipose, blood, and cellulose derived products (cells, decellularized matrices/scaffolds, and exosome/secretome factors) as a means to address this unmet medical need. The current status of this research area is evaluated and discussed in the context of promising avenues for future discovery.