This is a first observational case report defining the
resolution of a bedsore mediated through Exosomes from ADSC of Allogenic Fat. A
very widespread use of autologous fat transplant is a common procedure, and it
is a well-known way to treat bad healing wounds and to fill area of tissue
loss. Fat is harvested from patient as autologous fat. The use of exosomes,
microvesicles not carrying deoxyribonucleic acid (other than very little
portion of DNA whose importance is not clear) but miRNA, could be a new frontier
and foresee new therapy scenarios because of their possible use even from
homologous origin. Exosomes are membrane-bound extracellular vesicles that are
produced in the endosomal compartment of most eukaryotic cells and can transfer
molecules from one cell to another, thereby influencing the immune system and
may play a functional role in mediating adaptative immune response to pathogens
and tumors. An extraordinary explosion of interest is being addressed to
exosomes for many reasons. Mainly, they are thought to provide a means of
intercellular communication and of transmission of macromolecules between
cells. Second, they have been proposed to be useful vectors for drugs because
they are composed of cell membranes, rather than synthetic polymers, and are
better tolerated by the host. Chronic wound healing is a challenging medical
problem, which urgently requires anatomical and functional solutions.
Adipose-derived stem cells (ADSC) are mesenchymal stem cells with self-renewal
and multiple differentiation ability and play essential roles in wound healing
and tissue regeneration. Exosomes from ADSC are extracellular vesicles
essential for communication between cells. Exosomes from ADSC can restore
tissue homeostasis and accelerate wound healing by promoting various stage of
wound repair, including regulating the inflammatory response, promoting wound
angiogenesis, accelerating cell proliferation and modulating wound remodeling.
Compared with ADSC, exosomes have the advantage of avoiding medical issues, being
easily stored and having high stability. Following an admission to an intensive
care unit ward, in January 2014, the patient A.A., a woman suffering from ALS
and definitely lying in bed, did not receive any mobilization. I had the
opportunity to treat her bedsore with exosomes from ADSC of her husband,
achieving a resolution in few days after some months of unsuccessful
traditional plastic surgery care.
Specific guidelines on the use of microvesicles from
homologous origin, that a peer to peer commission and a consensus conference
would be set up, will have to be defined in order to avoid every attempt to
forward a “Miracle Therapy” and every “Pirate Business”, but also to deliver to
clinical use a safe and clever way to treat wounds.
Author(s) Details:
Erri Cippini,
Plastic Reconstructive and Aesthetic Surgery, Association of Medical
Doctors and Surgeons of the Province of Brescia, Italy.
Please see the link here: https://stm.bookpi.org/ANUMS-V3/article/view/13184
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