More than 2.5 million patients in the U.S. require treatment for
pressure ulcers annually, and the elderly are at particularly high risk for
pressure ulcer development. Current
therapy for
pressure ulcers consists of conservative medical management for shallow lesions and aggressive
debridement and surgery for deeper lesions. The current study uses a murine model to address the hypothesis that adipose-derived stromal/stem cell (ASC) treatment would accelerate and enhance
pressure ulcer repair. The dorsal skin of both young (2 months old [mo]) and old (20 mo) C57BL/6J female mice was sandwiched between external magnets for 12 hours over 2 consecutive days to initiate a
pressure ulcer. One day following the induction, mice were injected with ASCs isolated from congenic mice transgenic for the
green fluorescent protein under a ubiquitous promoter. Relative to
phosphate-buffered saline-treated controls, ASC-treated mice displayed a cell concentration-dependent acceleration of
wound closure, improved epidermal/dermal architecture, increased adipogenesis, and reduced inflammatory cell infiltration. The ASC-induced improvements occurred in both young and elderly recipients, although the expression profile of angiogenic, immunomodulatory, and reparative mRNAs differed as a function of age. The results are consistent with clinical reports that fat grafting improved skin architecture in thermal
injuries; the authors of this published study have invoked ASC-based mechanisms to account for their clinical outcomes. Thus, the current proof-of-principle study sets the stage for clinical translation of autologous and/or allogeneic ASC treatment of
pressure ulcers.
SIGNIFICANCE: Adipose-derived stromal/stem cells (ASCs) promote the healing of
pressure ulcer wounds in both young and old mice. ASCs enhance wound healing rates through adipogenic differentiation and regeneration of the underlying architecture of the skin.