背景:烧伤创伤是全世界发病率和死亡率的主要原因之一。烧伤伤口的标准处理包括早期清创,换装,手术管理,和厚薄皮肤自体移植物(STSGs)。然而,标准管理的局限性使我们倾向于寻找替代治疗方法,如创新的细胞疗法。我们旨在系统地回顾临床试验中基于细胞的烧伤创面治疗方法的不同方面。
方法:通过PubMed进行系统搜索,Medline,Embase,Cochrane图书馆数据库是使用关键字组合进行的,包括“细胞移植”,\"纤维母细胞\",“角质形成细胞”,“黑素细胞”,或带有“燃烧”的“干细胞”,“烧伤”或“烧伤”。首先,筛选了这些数据库中存在的直到“2024年2月”的研究的标题和摘要。然后,选定的研究被彻底阅读,考虑到纳入和排除标准,本系统综述包括最终文章.此外,我们通过纳入研究的参考列表进行了人工检索,以最大限度地降低缺失报告的风险.
结果:总体而言,我们的研究包括30项临床试验,其中970名患者。考虑到细胞的类型,六项研究使用角质形成细胞,九个用过的成纤维细胞,八种使用了角质形成细胞和成纤维细胞的组合,一项研究使用了角质形成细胞和黑素细胞的组合,五种联合使用的角质形成细胞、成纤维细胞和黑素细胞,一项研究使用间充质干细胞(MSC)。这些研究中对制剂类型的评估表明,在25项试验中使用了培养方法,5项试验采用非培养方法。此外,17项试验的移植物类型是同种异体的,其他13项试验是自体的。
结论:我们的研究表明,采用基于细胞的疗法治疗烧伤伤口在临床研究中取得了显著的成果,并且是有希望的方法,在许多情况下可以被视为替代治疗。然而,为每个烧伤伤口选择适当的基于细胞的治疗是至关重要的,并且取决于每个患者的情况。
BACKGROUND: Burn trauma is one of the major causes of morbidity and mortality worldwide. The standard management of
burn wounds consists of early debridement, dressing changes, surgical management, and split-thickness skin autografts (STSGs). However, there are limitations for the standard management that inclines us to find alternative treatment approaches, such as innovative cell-based therapies. We aimed to systematically review the different aspects of cell-based treatment approaches for
burn wounds in clinical trials.
METHODS: A systematic search through PubMed, Medline, Embase, and Cochrane Library databases was carried out using a combination of keywords, including \"Cell transplantation\", \"Fibroblast\", \"Keratinocyte\", \"Melanocyte\", or \"Stem Cell\" with \"
Burn\", \"
Burn wound\", or \"
Burn injury\". Firstly, titles and abstracts of the studies existing in these databases until \"February 2024\" were screened. Then, the selected studies were read thoroughly, and considering the inclusion and exclusion criteria, final articles were included in this systematic review. Moreover, a manual search was performed through the reference lists of the included studies to minimize the risk of missing reports.
RESULTS: Overall, 30 clinical trials with 970 patients were included in our study. Considering the type of cells, six studies used keratinocytes, nine used fibroblasts, eight used combined keratinocytes and fibroblasts, one study used combined keratinocytes and melanocytes, five used combined keratinocytes and fibroblasts and melanocytes, and one study used mesenchymal stem cells (MSCs). Evaluation of the preparation type in these studies showed that cultured method was used in 25 trials, and non-cultured method in 5 trials. Also, the graft type of 17 trials was allogeneic, and of 13 other trials was autologous.
CONCLUSIONS: Our study showed that employing cell-based therapies for the treatment of burn wounds have significant results in clinical studies and are promising approaches that can be considered as alternative treatments in many cases. However, choosing appropriate cell-based treatment for each burn wound is essential and depends on the situation of each patient.