Cargando…
Adjuvant Biological Therapies in Chronic Leg Ulcers
Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751164/ https://www.ncbi.nlm.nih.gov/pubmed/29182584 http://dx.doi.org/10.3390/ijms18122561 |
_version_ | 1783289887761367040 |
---|---|
author | Burgos-Alonso, Natalia Lobato, Igone Hernández, Igone Sebastian, Kepa San Rodríguez, Begoña Grandes, Gontzal Andia, Isabel |
author_facet | Burgos-Alonso, Natalia Lobato, Igone Hernández, Igone Sebastian, Kepa San Rodríguez, Begoña Grandes, Gontzal Andia, Isabel |
author_sort | Burgos-Alonso, Natalia |
collection | PubMed |
description | Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal stromal cell products, may form part of adjuvant interventions in an integral patient management. We synthesized the clinical experience on ulcer management using these two categories of biological adjuvants. The results of ten controlled trials that are included in this systematic review favor the use of mesenchymal stromal cell based-adjuvants for impaired wound healing, but the number and quality of studies is moderate-low and are complicated by the diversity of biological products. Regarding platelet-derived products, 18 controlled studies investigated their efficacy in chronic wounds in the lower limb, but the heterogeneity of products and protocols hinders clinically meaningful quantitative synthesis. Most patients were diabetic, emphasizing an unmet medical need in this condition. Overall, there is not sufficient evidence to inform routine care, and further clinical research is necessary to realize the full potential of adjuvant regenerative medicine strategies in the management of chronic leg ulcers. |
format | Online Article Text |
id | pubmed-5751164 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-57511642018-01-08 Adjuvant Biological Therapies in Chronic Leg Ulcers Burgos-Alonso, Natalia Lobato, Igone Hernández, Igone Sebastian, Kepa San Rodríguez, Begoña Grandes, Gontzal Andia, Isabel Int J Mol Sci Review Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal stromal cell products, may form part of adjuvant interventions in an integral patient management. We synthesized the clinical experience on ulcer management using these two categories of biological adjuvants. The results of ten controlled trials that are included in this systematic review favor the use of mesenchymal stromal cell based-adjuvants for impaired wound healing, but the number and quality of studies is moderate-low and are complicated by the diversity of biological products. Regarding platelet-derived products, 18 controlled studies investigated their efficacy in chronic wounds in the lower limb, but the heterogeneity of products and protocols hinders clinically meaningful quantitative synthesis. Most patients were diabetic, emphasizing an unmet medical need in this condition. Overall, there is not sufficient evidence to inform routine care, and further clinical research is necessary to realize the full potential of adjuvant regenerative medicine strategies in the management of chronic leg ulcers. MDPI 2017-11-28 /pmc/articles/PMC5751164/ /pubmed/29182584 http://dx.doi.org/10.3390/ijms18122561 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Burgos-Alonso, Natalia Lobato, Igone Hernández, Igone Sebastian, Kepa San Rodríguez, Begoña Grandes, Gontzal Andia, Isabel Adjuvant Biological Therapies in Chronic Leg Ulcers |
title | Adjuvant Biological Therapies in Chronic Leg Ulcers |
title_full | Adjuvant Biological Therapies in Chronic Leg Ulcers |
title_fullStr | Adjuvant Biological Therapies in Chronic Leg Ulcers |
title_full_unstemmed | Adjuvant Biological Therapies in Chronic Leg Ulcers |
title_short | Adjuvant Biological Therapies in Chronic Leg Ulcers |
title_sort | adjuvant biological therapies in chronic leg ulcers |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751164/ https://www.ncbi.nlm.nih.gov/pubmed/29182584 http://dx.doi.org/10.3390/ijms18122561 |
work_keys_str_mv | AT burgosalonsonatalia adjuvantbiologicaltherapiesinchroniclegulcers AT lobatoigone adjuvantbiologicaltherapiesinchroniclegulcers AT hernandezigone adjuvantbiologicaltherapiesinchroniclegulcers AT sebastiankepasan adjuvantbiologicaltherapiesinchroniclegulcers AT rodriguezbegona adjuvantbiologicaltherapiesinchroniclegulcers AT grandesgontzal adjuvantbiologicaltherapiesinchroniclegulcers AT andiaisabel adjuvantbiologicaltherapiesinchroniclegulcers |