Persistence of bilayered living-cell therapy donor DNA 10 months after application: a case report.
Bilayered living-cell therapy has been shown in clinical trials to improve the rate of healing diabetic and venous leg ulcerations. However, literature is conflicted regarding the length of time living-cell therapy persists in acute and chronic wounds. An otherwise healthy 48-year-old man with sepsis from extensive lower-extremity wounds due to ecthyma gangrenosum was admitted to the hospital. Initial treatment consisted of surgical debridement, broad-spectrum antibiotics, and stabilization in the intensive care unit. After the patient was stabilized, three units of living-cell therapy meshed at a 3:1 ratio were applied to the wounds. Both wounds were healed after 20 weeks. Ten months post grafting, the patient returned with a recurrent ulcer in the area of graft placement. A biopsy of the wound for human leukocyte antigen revealed the presence of donor DNA from the bilayered living-cell therapy. This case suggests that bilayered living-cell therapy may persist for prolonged periods in patients without underlying skin disease or immunosuppression. Research to explicate the mode of action and optimal protocols for use of living-cell therapy is warranted.
Serena
Thomas E
TE
Penn North Centers for Advanced Wound Care, 552 Quaker Hill Rd, Warren, PA 16365, USA. serena@healingwounds.com
Bialas
Paul
P
D002478:Cells, Cultured; D003094:Collagen / Q000627:therapeutic use*; D004247:DNA / Q000378:metabolism*; D003646:Debridement; D005347:Fibroblasts / Q000637:transplantation*; D006085:Graft Survival / Q000235:genetics*; D006801:Humans; D015603:Keratinocytes / Q000637:transplantation*; D007871:Leg Ulcer / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D017768:Skin, Artificial; D014945:Wound Healing; D014946:Wound Infection / Q000473:pathology / Q000628:therapy*
D003094:Collagen; D004247:DNA