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Int. J. Mol. Sci. 2017, 18(12), 2561; https://doi.org/10.3390/ijms18122561

Adjuvant Biological Therapies in Chronic Leg Ulcers

1
Primary Care Research Unit of Bizkaia, BioCruces Health Research Institute, 48014 Bilbao, Spain
2
Preventive Medicine and Public Health Department, Faculty of Medicine and Odontology, Universidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHU, University of the Basque Country, 48940 Lejona, Spain
3
Enkarterrri-Ezkerraldea-Cruces Health Region, Basque Health Service (Osakidetza), 48903 Barakaldo, Spain
4
Bilbao-Basurto Health Region, Basque Health Service (Osakidetza), 48014 Bilbao, Spain
5
Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital, 48903 Barakaldo, Spain
*
Author to whom correspondence should be addressed.
Received: 3 November 2017 / Revised: 22 November 2017 / Accepted: 28 November 2017 / Published: 28 November 2017
(This article belongs to the Special Issue Inflammatory Skin Conditions 2017)
View Full-Text   |   Download PDF [1746 KB, uploaded 29 November 2017]   |  

Abstract

Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal stromal cell products, may form part of adjuvant interventions in an integral patient management. We synthesized the clinical experience on ulcer management using these two categories of biological adjuvants. The results of ten controlled trials that are included in this systematic review favor the use of mesenchymal stromal cell based-adjuvants for impaired wound healing, but the number and quality of studies is moderate-low and are complicated by the diversity of biological products. Regarding platelet-derived products, 18 controlled studies investigated their efficacy in chronic wounds in the lower limb, but the heterogeneity of products and protocols hinders clinically meaningful quantitative synthesis. Most patients were diabetic, emphasizing an unmet medical need in this condition. Overall, there is not sufficient evidence to inform routine care, and further clinical research is necessary to realize the full potential of adjuvant regenerative medicine strategies in the management of chronic leg ulcers. View Full-Text
Keywords: biological therapies; chronic leg ulcer; platelet rich plasma; bone marrow concentrates; stromal vascular fraction; mesenchymal stromal cells biological therapies; chronic leg ulcer; platelet rich plasma; bone marrow concentrates; stromal vascular fraction; mesenchymal stromal cells
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Burgos-Alonso, N.; Lobato, I.; Hernández, I.; Sebastian, K.S.; Rodríguez, B.; Grandes, G.; Andia, I. Adjuvant Biological Therapies in Chronic Leg Ulcers. Int. J. Mol. Sci. 2017, 18, 2561.

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