Mesenchymal Stromal Cells for Wound Healing Therapy: From Expectations to Reality

This chapter addresses the therapeutic potential of mesenchymal stromal/stem cells (MSCs), focusing on those derived from bone marrow and adipose tissue to be used for skin wound healing. The documented ability of this type of cells to promote the resolution of cutaneous lesions has been initially attributed to their differentiation potential. Therefore, after a brief introduction about isolation and in vitro characterization, this chapter will be focused on the available information regarding the MSCs capacity to differentiate towards cell types relevant to the healing process, like keratinocytes. Another proposed mechanism involved in the beneficial effects of MSCs refers to their paracrine action, which includes the plethora of secreted factors as well as extracellular vesicles (EVs), which can mediate several phases of the wound healing process. Therefore, after exploring the effects of MSCs secretome on inflammation, reepithelialization, matrix remodeling, and angiogenesis, the action of individual effectors classes secreted by these cells, more precisely: growth factors and extracellular vesicles with a focus on exosomes (Exo) will be presented. Finally, the outcomes of several clinical trials up to date and novel methods employed to maximize MSCs efficacy for skin wound healing will be reviewed.