Artificial skin has achieved considerable therapeutic results in clinical practice. However,
artificial skin treatments for
wounds in diabetic patients with impeded blood flow or with large
wounds might be prolonged. Cell-based
therapies have appeared as a new technique for the treatment of diabetic
ulcers, and cell-sheet engineering has improved the efficacy of
cell transplantation. A number of reports have suggested that adipose-derived stem cells (ASCs), a type of mesenchymal stromal cell (MSC), exhibit therapeutic potential due to their relative abundance in adipose tissue and their accessibility for collection when compared to MSCs from other tissues. Therefore, ASCs appear to be a good source of stem cells for
therapeutic use. In this study, ASC sheets from the epididymal adipose fat of normal Lewis rats were successfully created using temperature-responsive culture dishes and normal culture medium containing
ascorbic acid. The ASC sheets were transplanted into Zucker diabetic fatty (ZDF) rats, a rat model of
type 2 diabetes and
obesity, that exhibit diminished wound healing. A
wound was created on the posterior cranial surface, ASC sheets were transplanted into the
wound, and a bilayer
artificial skin was used to cover the sheets. ZDF rats that received ASC sheets had better wound healing than ZDF rats without the
transplantation of ASC sheets. This approach was limited because ASC sheets are sensitive to dry conditions, requiring the maintenance of a moist
wound environment. Therefore,
artificial skin was used to cover the ASC sheet to prevent drying. The allogenic
transplantation of ASC sheets in combination with
artificial skin might also be applicable to other intractable
ulcers or
burns, such as those observed with
peripheral arterial disease and
collagen disease, and might be administered to patients who are undernourished or are using
steroids. Thus, this treatment might be the first step towards improving the therapeutic options for diabetic wound healing.