Stem cells have become a topic of high interest in medicine and research due to their ability to differentiate into different cell types, influence tissue growth, and rebuild tissue. It is because of these special characteristics that they are now a focus in healing many kinds of wounds. The purpose of researching how stem cells can heal tissue can end up being an important breakthrough that can change how we heal complex wounds and help patients that may have obstacles that inhibit their recovery. There are many kinds of wounds that stem cells have been proven to help heal more efficiently such as burn wounds, damaged skin, bone and diabetic injuries, tympanic perforations, and damage that resulted from radiation. The objective of this paper is to cover all the different kinds of wounds that stem cells have been noted to reconstruct.
Burn Wounds, Skin Damage, Enhancing Healing of Sutured Tissue
With the rapid development of medical research on the proper integration of stem-cells, the medical intervention of stem-cells in the treatment of severe burn wounds and skin damages are shown to prevent excessive bleeding and infection throughout various studies conducted (Ke et al. 2015). In a joint-research study conducted between PhD candidates from the University of Texas and Yonsei University of South Korea, male rats aged between 8 to 10 weeks were tested in the effectiveness of using adipose tissue-derived stem cells as medical treatment in closing burn wounds. Adipose tissue-derived stem cells (ASCs) were collected beforehand from the epididymal fat pads of lab rats, and burn wounds were created by placing heat brass plates (87°C) that weighed 500g on the dorsal area of the lab rats for 10 seconds. The research is then conducted by injecting the ASCs added with P-fibrin near the burn wound, where the stem cells are allowed to transmigrate into the regenerating wound and aid the regeneration process of lost tissue. Burn wounds were then carefully monitored day to day through medical scans and imaging, and the results that were collected over the course of a week exhibited an enhancement in tissue granulation (Eunna et al. 2016). The combined application of P-fibrin and ASCs also led to an earlier neovascularization of regenerating tissue, where the process of angiogenesis was significantly increased in regenerating burn wounds.
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In a similar research study done by Burn & Plastic Surgery professionals of the General Hospital of Beijing, China, the utilization of human umbilical cord mesenchymal stem cells (MSCs) were applied and injected into or near burn wounds created to test the effect and reaction response of the transmigrating stem cells. Data collected after observing the burn wounds revealed similar results, where the burn wounds of lab rats that were injected with MSC-infused gel demonstrated a significant improvement in wound healing in comparison to the lab rats that did not receive any medical injections (Liu et al. 2014). In addition, the ratio of collagen and neovascularization of the regenerating tissue near the burn wounds were also remarkably lower within the control groups. Thus, concluding that stem cells enhance the regeneration of tissue near burn wounds.
Perforation of tympanic membrane
In some cases, with perforations in tympanic membranes, tympanoplasty might not be a practical way to heal the puncture wounds. There are situations where some patients suffer from unproductive healing, are unable to handle the surgical procedure required, or cannot afford the treatment. It is because of these obstacles that some are looking into procedures that do not require the tympanoplasty surgery. Mesenchymal stem cells are a good start for putting together a healing procedure because they are easy to make, they produce cytokines and growth factors that increase the rate of healing, they trigger nearby progenitor stem cells, and they regulate the inflammatory and immune responses of the body (Goncalves et al. 2016). In one study of tympanic membrane healing, there were three groups of mice that got tympanic membrane perforations. One of the groups, the control group, did not receive any treatment after the perforation of their ear drums, while the other two groups did receive stem cell treatment. There was also an additional mouse that was used as a normal specimen for comparison; it did not have its tympanic membrane perforated. When comparing the membranes, it was noted that the normal mouse had the three regions of its tympanic membrane intact. When looking at the untreated, perforated group, there were many inflammatory cells crowding the punctured tympanum; the three layers that were present in the normal mouse ear also seemed to be broken up. As for the groups that were treated with stem cells and hyaluronic acid scaffold, their tympanic membranes looked like they were showing more signs of healing because they had organized the three layers that are noticed in the normal mouse ear drum; the three layers being the epithelial, mucosa, and lamina propria. It seemed that the healing ability of the stem cells in this study might have come from not only their differentiation, but also their other features like their influence on inflammation and production of trophic factors. In conclusion, there seems to be a high likelihood of stem cell use in tympanic membrane healing in the future.
Diabetic foot injuries
Along with the growing rate of obesity around the globe, the need for treatment of medical conditions such as diabetes and medical complications that come associated with this condition increases over time. One specific medical complication that can utilize the advantages of integrating adipose tissue-derived stem cells are diabetic foot injuries. In a joint-research study done by PhD and medical professionals of Pamukkale University, the study focused on the usage of stem cells derived from umbilical cord blood as a form of treatment to diabetic foot injuries. As previously examined in various other scenarios, stem cells are proven to aid with the regeneration of tissue by increasing the overall process of angiogenesis and neovascularization of tissue when properly injected nearby wounds and tissues (Cil et al. 2016). In this research, Cil, along with other medical professionals, combined CD34 with stem cells obtained from human umbilical blood in wound healing by injecting the solution into a rat model and examining the effects and ramifications. The rat model was divided into two groups, where both groups were diabetic and fresh wounds were cut open on the soles of their feet. The control group are left alone, while the other group were locally injected with 0.5×106 of the CD34+stem cells solution. The results gathered over a period revealed that the new skin formed near foot wounds after the CD34+stem cell treatment had healed significantly better in comparison to the control group due to the increased rate of angiogenesis and neovascularization of regenerating tissues from the medical injection. Because of this finding, medical professionals are positive with the implementation and application of stem cells in the future as a method of better treating medical conditions such as diabetic foot injuries.
Stem cells also play a prevalent role in the quality of bone healing around implants, as numerous researched studies have concluded the effectiveness of utilizing adipose tissue-derived stem cells. Osseointegration of implants is the direct functional and structural connection between the artificial implant and the living bone structure. In which ASCs plays a vital role in modern medical surgery procedures as the need for osseointegration surgeries are increasing in frequency due accidents and natural illnesses, and the improved process of osseointegration through the proper implementation of adipose tissue-derived stem cells will greatly benefit the society. In a recent joint-research study done by medical professionals and engineers from Iran and the United Kingdom, the researchers focused primarily on the effect of applied adipose tissue-derived stem cells on titanium implants in lab rats and the overall osseointegration in low-density bones (Golab et al. 2015). The overall success of osseointegration of implants generally rests upon three main factors: biomaterial of implant, bone quality and surgical techniques of the medical professional. In this study, the researchers pursed to optimize the cellular characteristics around implants in low-density bones of lab rats. Results collected showed a positive influence in regeneration of bone around implants when ASCs were administered, as well as improved regulation of osteoprogenitor cells therefore leading to an improvement in osseointegration of implants. Hence, the proper utilization of MSCs within the osseointegration process will improve and attribute to the success of the medical implant.
Stem cells also have been noted to be useful in healing the damage caused by radiation treatments. In another study, researchers looked at how adipose (fat) stem cells could treat chronic wounds caused by radiation (Huang et al. 2013). Although radiation treatment for cancer has improved a lot over the years, it still causes problems because it is difficult to heal with surgery, and it takes a toll on patients and contributes to financial problems. Chronic wound caused by radiation can also last for many years and could end in amputation. Part of why radiation causes so much damage to cells is the fact that it disrupts cell DNA, which leads to apoptosis (also known as cell death). Because adipose stem cells are so easy to produce in large amounts and they can become different cell types, they make the perfect material for healing tissue damage caused by radiation; they could heal the wound through angiogenesis, which is the development of new blood vessels. After comparing the different tissue samples, it became clear that the samples that were treated with adipose stem cells had an increase in blood supply and granulation when compared to those who were not; the stem cell treated tissue showed more capillary density and increased the thickness of the dermis that had suffered from radiation. In summary, there is room for radiation healing in the future with stem cells.
In brief, stem cell research is showing more and more promise as more supportive research is being added to improve our understanding of how the cells function in healing injured tissue. What we have gained from all the research that we have collected so far is that stem cells have other features that are beyond just the cells themselves and their ability to become other specialized cells. The stem cells are also capable of releasing trophic factors, which support cells, and regulating of inflammation. There is still plenty of research that needs to be done to learn more about how the cells contribute to healing, but overall the use of stem cells in the future can be a crucial gamechanger.
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