Use of stem cells in treatment of 3rd degree burn

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stem cells in burn treatment &
tissue regeneration
Vishesh Mishra
M.Sc 1st

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Introduction:-
A third-degree burn is the most severe type of burn, in
which all layers of the skin and underlying tissue are
damaged or destroyed. This type of burn can be caused by
exposure to heat, electricity, chemicals, or radiation. Third-
degree burns are typically painless because the nerve
endings have been destroyed.
Complications from a third-degree burn can be severe and
life-threatening. One of the most common complications is
infection, which can occur if the burn is not properly cleaned
and treated.
Another complication of third-degree burns is hypovolemic
shock, which occurs when the body loses too much blood
or other fluids.
Third-degree burns can also cause scarring and
disfigurement, especially if they occur on the face or other
visible areas of the body. This can have a significant impact
on a person's quality of life, causing emotional and
psychological distress.

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Treatment:-
 Skin grafting is a common treatment option for third-degree
burns, which are the most severe type of burn that can damage
all layers of the skin and underlying tissues. Skin grafting
involves transplanting healthy skin from another part of the
body, or from a donor, onto the burned areas
 The process of skin grafting begins by removing healthy skin
from a donor site, typically an area of the body that is hidden or
can be covered easily, such as the thigh . This skin is then
carefully placed onto the burned area and secured with sutures
or staples.
 After the graft is in place, the patient will need to keep the area
elevated and immobilized to allow the graft to adhere to the
underlying tissue .Over time, the graft will begin to integrate
with the surrounding tissue, creating a new layer of healthy skin

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Drawbacks:-
graft limitation
• Autograft • limited availability
• Pain and discomfort
• Poor healing
• Infection
• Scarring
• Cost
• Isograft • rejection
• Frequent replacement
• Cost
• Scarring
• Allograft • Rejection
• Infection
• Scarring
• Cost
• Limited integration
• Xenograft • rejection
• Infection
• Short lifespan
• Disease transmission
• Poor cosmetic result

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Modification:-
 skin wound healing comprises four phases: coagulation, inflammation ,proliferation
(epithelization, angiogenesis) and maturation (collagen deposit, formation of scaring
tissue) . STEM CELLS aid in all phases of the wound healing process. Application of stem
cells for skin therapy can enhance wound healing and curtail scarring. Stem cells migrate
to the spot of skin injury, inhibit inflammation, and elevate the proliferation and
differentiation potential of fibroblasts, epidermal cells, and endothelial cells. The
inflammatory phase is important for the wound healing process, as it leads to the
recruitment of immune cells to reduce pathogens and clear the injury. However, chronic
inflammation can postpone skin healing. SCs can inhibit inflammatory responses in
several ways , research has showed that SCs promote polarization of macrophages to an
M2-like phenotype(a type of macrophage that reduces inflammation and
immunosuppressive function ). Moreover, the SC-induced M2-like phenotype
macrophages interact with natural killer (NK) cells and inhibit the expression of NK
activation-related proteins such as NKp44, CD25, CD69, and interferon-gamma (IFN-γ).
Furthermore, SC can inhibit T cell proliferation by promoting the multiplication of T-
regulatory cells.

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• Advantages of Mesenchymal stem cells ;-
 (a) They have stemness potency.
 b) They are easy to isolate from original tissues.
 (c) They have less severe ethical issues as
compared to embryonic stem cells (ESC).
 (d) Unlike induced pluripotent stem cells (iPSC),
they carry a lower risk of teratoma-formation .
 (e) They are useful for a variety of therapeutic
applications because of their ability to migrate to
damaged tissue by chemoattraction .
STEM CELLS
IPSC’s
Embryonic stem cells
Neural stem cells
Hematopoietic stem cells
Mesenchymal stem cells

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Delivery SC’s using lipid nanoparticles
 Such methods utilize preparations, which include a therapeutic agent loaded
within lipid molecule (e.g., liposomes) or accompanied with skin permeation
agent such that absorption of the active ingredient through the skin is
enhanced. Such preparations can be directly applied to a skin region or
delivered via trans dermal devices such as membranes, skin patches etc.
 In transdermal delivery, the active ingredient penetrates the skin and enters
the capillary blood or the lymph circulation system, which carries the
therapeutic agent to the target organ or to the tissue or has a local effect.
 For several years, transdermal drug delivery systems have been employed to
effectively introduce a limited number of drugs through unbroken skin.
 Aside from comfort and convenience, transdermal systems avoid the barriers,
delivery rate control problems and potential toxicity concerns associated with
traditional administration techniques, such as oral, intramuscular or
intravenous delivery

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• Scarring?
 A coacervate is a spherical aggregation of lipid molecules making up a colloidal inclusion,
which is held together by hydrophobic forces.
 More plainly stated; it is usually a little ball of organic matter which is formed by the
repulsion of water by something like an oil
 Although there are numerous medical applications to recover damaged skin tissue, scarless
wound healing is being extensively investigated to provide a better therapeutic outcome. The
exogenous delivery of therapeutic growth factors (GFs) is one of the strategies for skin
regeneration. The use of an exogenous GF delivery platform developed using coacervates
(Coa) along with, heparin, and cargo GFs (i.e., transforming growth factor beta 3 (TGF-
β3)(helps control the growth and division (proliferation) of cells) and interleukin 10 (IL-
10)(anti-inflammatory cytokine). Coa encompasses the advantage of high biocompatibility,
easy preparation, protection of cargo GFs, and sustained GF release. We therefore
speculated that coacervate-mediated dual delivery of TGF-β3/IL-10 would exhibit synergistic
effects for the reduction of scar formation during physiological wound healing.

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