Wound therapy by marrow mesenchymal cell transplantation.
BACKGROUND
Marrow mesenchymal cells are useful in regenerative medicine because they contain stem cells, but there have been few reports of clinical applications. The authors developed a new wound treatment technique by improving marrow mesenchymal cell culture methods and placing cultured cells in an artificial skin material. This new treatment was useful for tissue regeneration in 20 patients with skin wounds.


METHODS
Marrow mesenchymal cells from a 46-year-old man were cultured and placed in artificial dermis made of collagen sponge. This composite graft was implanted subcutaneously into the back of a nude mouse and removed 10 days later; immunohistological analysis confirmed regeneration of subcutaneous tissue using human marrow mesenchymal cells. Next, in 20 patients (nine men and 11 women; average age, 64.8 years; range, 22 to 91 years) with intractable dermatopathies, 10 to 20 ml of bone marrow fluid was aspirated from the ilium and cultured in medium containing either fetal calf or autologous serum. The resulting cultured cells were placed in artificial dermis made of collagen sponge, and this composite graft was used to treat skin wounds.


RESULTS
The wound mostly healed in 18 of the 20 patients; the remaining two patients died of causes unrelated to transplantation. In all patients, autologous marrow mesenchymal cell transplantation was shown to be therapeutically effective.


CONCLUSIONS
In skin regeneration therapy using a marrow mesenchymal cell/artificial dermis composite graft, skin regeneration is possible with bone marrow aspiration, a minimally invasive procedure. Compared with existing skin grafting techniques, the present technique is practical and much less invasive.
Yoshikawa
Takafumi
T
Kashihara and Yamatokohriyama, Nara, Japan From the Departments of Orthopedic Surgery, Emergency and Critical Care Medicine, and Diagnostic Pathology, Nara Medical University, and Seiran Hospital.
Mitsuno
Hiroya
H
Nonaka
Iehisa
I
Sen
Yasunori
Y
Kawanishi
Kouichi
K
Inada
Yuji
Y
Takakura
Yoshinori
Y
Okuchi
Kazuo
K
Nonomura
Akitaka
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016026:Bone Marrow Transplantation; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D012038:Regeneration / Q000502:physiology*; D012867:Skin; D017768:Skin, Artificial; D014182:Transplantation, Autologous; D014945:Wound Healing; D014947:Wounds and Injuries / Q000601:surgery*