Regenerative Potential of Adipose Derived Stem Cells in Wound Healing and Scar Management: A Review

Abstract

Objective: The objective of this research paper is to explore the role of adipose-derived stem cells (ADSCs) in wound healing. Methods: An overview of the current knowledge and application of adipose derived stem cells in wound healing has been conducted, based on existing studies. A multistep search of the PubMed database was performed to identify papers on ADSCs and their role in wound healing. Of the 151 articles initially identified, 73 articles focusing on regenerative strategies in wound healing were selected and, consequently, only those articles were initially assessed for eligibility. Then, 13 articles of these were excluded due to inaccessibility. The remaining 60 articles, strictly regarding the application of ADSCs in wound healing, were analyzed. Discussion: ASCs enhance wound healing through paracrine signaling, exosome secretion, and macrophage polarization. They promote angiogenesis, epithelialization, and extracellular matrix formation. Exosomes from ASCs (AEXOs) carry molecules that boost cell proliferation and wound regeneration via the TGF-β/Smad3 pathway, encouraging collagen synthesis. Clinical applications of ASCs have shown effectiveness in treating various wounds, including radiation-induced wounds and diabetic ulcers. Extraction methods, such as liposuction followed by filtration, collagenase digestion, and centrifugation, yield high cell viability. Fat-derived pellets (FDP) maintain high viability and enhance healing. Scaffolds like PLGA/Gelatin/Hyaluronic Acid, hyaluronic acid with PRP, and Catechol-Functionalized Hyaluronic Acid Patch support cell growth, angiogenesis, and collagen production, improving healing outcomes.ASCs effectively treat diabetic wounds, radiation-induced wounds, pressure ulcers, and burn wounds. They accelerate tissue regeneration, speed wound closure, improve scar flexibility, and reduce inflammation. ASCs also aid in scar management, reducing scar size and improving collagen structure. Challenges include optimizing delivery methods, dosages, and safety concerns. Understanding epithelial restoration mechanisms is crucial, with research needed on potential de-differentiation or trans-differentiation of mesodermal cells into ectodermal cells. Conclusion: ADSCs have a significant role in wound healing and show great potential as a therapeutic option. However, further studies are needed is needed to address the challenges and limitations of this therapy and improve its effectiveness and safety.