1) Mesenchymal bone marrow stem cells more effectively stimulate regeneration of deep burn wounds than embryonic fibroblasts. When seeded together with keratinocytes onto a collagen matrix, mesenchymal stem cells promote stratification and proliferation of keratinocytes, resulting in a fully differentiated multilayered epidermis.
2) Keratinocytes seeded alone onto the collagen matrix only formed a thin, irregular epidermal layer and invaded into the collagen spongy structure.
3) The results suggest that direct intercellular contact between mesenchymal stem cells and keratinocytes is required for skin-specific morphology, and co-cultures may improve composite skin substitutes for burn regeneration.
The term artificial skin is used to describe any material used to replace (permanently or temporarily) or to mimic the dermal and epidermal layers of the skin.
The primary current application of artificial skin is for the treatment of skin loss or damage on burn patients.
Alternatively however, artificial skin is now being used in some places to treat patients with skin diseases, such as diabetic foot ulcers, and severe .
The use of stem cells in burnt wound treatmentNavya_Sharma
clinical reasearches prooved that cell based therapy can be considered as an important alternative for burn wound management. Know all facts and benefits here visit, https://www.cordlifeindia.com/
What is Stem Cell ?
History of Stem Cells ?
Stages of Embryogenesis
Blastocyst Diagram
Three types of stem cells
Differentiation of ESC
Adult Stem Cells
Bone Marrow
Umbilical cord stem cells
Factors known to affect stem cells
Niche cells activates Stem cells
Regenerative Medicine : Indian Scenario
The term artificial skin is used to describe any material used to replace (permanently or temporarily) or to mimic the dermal and epidermal layers of the skin.
The primary current application of artificial skin is for the treatment of skin loss or damage on burn patients.
Alternatively however, artificial skin is now being used in some places to treat patients with skin diseases, such as diabetic foot ulcers, and severe .
The use of stem cells in burnt wound treatmentNavya_Sharma
clinical reasearches prooved that cell based therapy can be considered as an important alternative for burn wound management. Know all facts and benefits here visit, https://www.cordlifeindia.com/
What is Stem Cell ?
History of Stem Cells ?
Stages of Embryogenesis
Blastocyst Diagram
Three types of stem cells
Differentiation of ESC
Adult Stem Cells
Bone Marrow
Umbilical cord stem cells
Factors known to affect stem cells
Niche cells activates Stem cells
Regenerative Medicine : Indian Scenario
For better view, press F5.
As we go through our lives each of us will have very different needs for our own healthcare.
Scientist's are constantly researching to make medical care treatment more personalized.
One way they are doing this is by-
Stem Cells therapy
Stem-cell therapy is the use of stem cells to treat or prevent a disease or condition.
It is also known as regenerative medicine, promotes the reparative response of diseased, dysfunctional or injured tissue using stem cells or their derivatives.
It is the next chapter of organ transplantation and uses cells instead of donor organs, which are limited in supply.
What are Stem cells?
Stem cells are called “master cells”
Stem cells are cells that are undifferentiated.
What are Stem cells?
Steam cells have the potential to become all other kinds of cells in our body.
What are Stem cells?
Types of Stem cells
How stem cell therapy works?
Disease cured by stem cell therapy.
Spinal Cord Injuries
Stem cell treatment of Diabetes mellitus type 1 & 2
Stem cell treatment of Stroke
Cancer treatment
Heart damage
Baldness
Tooth implanting
Deafness and blindness
Have stem cells already been used to treat diseases?
Ethical Consideration of Stem Cell Therapy
As the research method mainly focused on Embryonic Stem Cells, which involves taking tissue from an aborted embryo to get proper material to study. This is typically done just days after conception or between the 5th and 9th week.
Since then, researchers have moved on to more ethical study methods, such as Induced Pluripotent Stem Cells (iPS). iPS is artificially derived from a non-pluripotent cell, such as adult somatic cells.
Nowadays stem cell treatment has been spreaded throughout the world. It has also been grown commercially in developed countries.
It is thought that one day it may be the major key to treat various diseases.
Using stem cells to conduct medical research and treat disease is acceptable?
Don’t know
No
Yes
Do you approve of the extraction of stem cells from human embryos for medical research?
Don’t know
No
Yes
Introduction
Artificial skin
Invention
Structure of human skin
Importance of skin
Key development
Biomaterials
Methods to produce artificial skin
Application
Problems
Future development
Conclusions
references
what is tissue engineering
Sources of tissue grafting
Strategies for tissue engineering
Stem cells
Several strategies are now available for developing new organs and tissues
What is the scaffold?
Ideal properties of scaffold
Scaffolding procedures
BIOMATERIALS AND SCAFFOLDS
CAD-CAM technique for scaffolding design
CELL CULTURE METHODS
TISSUE-ENGINEERED DENTAL TISSUES
Stem cells
Undifferentiated cells capable of self-renew and to differentiate into different cell types or tissues during embryonic development and throughout adulthood.
Have possibility to become a specialised cell.
Have the ability to divide continuously and develop into various other kinds of cells.
Have immune potential and can help to treat a wide range of medical problems.
Discovery of stem cells lead to a whole new branch of medicine known as Regenerative medicine.
It deals with application of such genes and proteins obtained from the animals especially for medicine and also industries. It is much useful to understand the basic.
Artificial skin is a collagen scaffold that induces regeneration of skin in mammals such as humans. The term was used in the late 1970s and early 1980s to describe a new treatment for massive burns.
For better view, press F5.
As we go through our lives each of us will have very different needs for our own healthcare.
Scientist's are constantly researching to make medical care treatment more personalized.
One way they are doing this is by-
Stem Cells therapy
Stem-cell therapy is the use of stem cells to treat or prevent a disease or condition.
It is also known as regenerative medicine, promotes the reparative response of diseased, dysfunctional or injured tissue using stem cells or their derivatives.
It is the next chapter of organ transplantation and uses cells instead of donor organs, which are limited in supply.
What are Stem cells?
Stem cells are called “master cells”
Stem cells are cells that are undifferentiated.
What are Stem cells?
Steam cells have the potential to become all other kinds of cells in our body.
What are Stem cells?
Types of Stem cells
How stem cell therapy works?
Disease cured by stem cell therapy.
Spinal Cord Injuries
Stem cell treatment of Diabetes mellitus type 1 & 2
Stem cell treatment of Stroke
Cancer treatment
Heart damage
Baldness
Tooth implanting
Deafness and blindness
Have stem cells already been used to treat diseases?
Ethical Consideration of Stem Cell Therapy
As the research method mainly focused on Embryonic Stem Cells, which involves taking tissue from an aborted embryo to get proper material to study. This is typically done just days after conception or between the 5th and 9th week.
Since then, researchers have moved on to more ethical study methods, such as Induced Pluripotent Stem Cells (iPS). iPS is artificially derived from a non-pluripotent cell, such as adult somatic cells.
Nowadays stem cell treatment has been spreaded throughout the world. It has also been grown commercially in developed countries.
It is thought that one day it may be the major key to treat various diseases.
Using stem cells to conduct medical research and treat disease is acceptable?
Don’t know
No
Yes
Do you approve of the extraction of stem cells from human embryos for medical research?
Don’t know
No
Yes
Introduction
Artificial skin
Invention
Structure of human skin
Importance of skin
Key development
Biomaterials
Methods to produce artificial skin
Application
Problems
Future development
Conclusions
references
what is tissue engineering
Sources of tissue grafting
Strategies for tissue engineering
Stem cells
Several strategies are now available for developing new organs and tissues
What is the scaffold?
Ideal properties of scaffold
Scaffolding procedures
BIOMATERIALS AND SCAFFOLDS
CAD-CAM technique for scaffolding design
CELL CULTURE METHODS
TISSUE-ENGINEERED DENTAL TISSUES
Stem cells
Undifferentiated cells capable of self-renew and to differentiate into different cell types or tissues during embryonic development and throughout adulthood.
Have possibility to become a specialised cell.
Have the ability to divide continuously and develop into various other kinds of cells.
Have immune potential and can help to treat a wide range of medical problems.
Discovery of stem cells lead to a whole new branch of medicine known as Regenerative medicine.
It deals with application of such genes and proteins obtained from the animals especially for medicine and also industries. It is much useful to understand the basic.
Artificial skin is a collagen scaffold that induces regeneration of skin in mammals such as humans. The term was used in the late 1970s and early 1980s to describe a new treatment for massive burns.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Mastering Wealth: A Path to Financial FreedomFatimaMary4
### Understanding Wealth: A Comprehensive Guide
Wealth is a multifaceted concept that extends beyond mere financial assets. It encompasses a range of elements including money, investments, property, and other valuable resources. However, true wealth also includes non-material aspects such as health, relationships, and personal fulfillment. This guide delves into the various dimensions of wealth, exploring how it can be created, sustained, and enjoyed.
#### Defining Wealth
Traditionally, wealth is defined as the abundance of valuable resources or material possessions. It includes financial assets like cash, savings, stocks, bonds, and real estate. However, a broader understanding of wealth considers factors such as personal well-being, emotional health, social connections, and intellectual growth. This holistic view recognizes that true wealth is not solely about accumulating money but also about enhancing one's quality of life.
#### The Importance of Financial Wealth
Financial wealth remains a critical component of overall wealth. It provides security, freedom, and the ability to pursue opportunities. Key elements of financial wealth include:
1. **Savings**: Money set aside for future use. It is crucial for emergencies, large purchases, and financial goals.
2. **Investments**: Assets purchased with the expectation that they will generate income or appreciate over time. Common investments include stocks, bonds, mutual funds, real estate, and businesses.
3. **Income**: Regular earnings from work, investments, or other sources. Consistent income is essential for maintaining and growing wealth.
4. **Debt Management**: Effectively managing debt ensures that it does not erode financial wealth. This includes paying off high-interest debt and using credit wisely.
#### Creating Wealth
Creating wealth involves generating and accumulating financial and non-financial resources. The process can be broken down into several key strategies:
1. Education and Skill Development: Investing in education and skills enhances earning potential. Higher education, professional certifications, and continuous learning can lead to better job opportunities and higher salaries.
2. Entrepreneurship: Starting and running a successful business can be a significant source of wealth. Entrepreneurship requires innovation, risk-taking, and effective management.
3. Investing: Making smart investments is essential for wealth creation. This involves understanding different types of investments, assessing risks, and making informed decisions. Diversifying investments can reduce risk and increase potential returns.
4. Saving and Budgeting: Effective saving and budgeting help accumulate wealth over time. Setting financial goals, creating a budget, and sticking to it are foundational steps in wealth creation.
5. Real Estate: Investing in property can provide rental income and capital appreciation. Real estate is a tangible asset that can hedge against inflation
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
1. Introduction
Burn
• Tissue disruption due contact to source: thermal
The use of Stem cells (burn/scald), chemical, electrical (lightning), radiation.
in burn care • Problems encountered:
– Acute phase
• Deterioration of airway, breathing and circulation
• Systemic Inflammatory Response Syndrome
Yefta Moenadjat (SIRS) & Multi-system Organ Dysfunction
Syndrome (MODS)
– Late phase
• Wound healing
Introduction Superficial burn
Burn • Epidermal layer disruption
• Intact dermal
• Tissue disruption: wound classification
• Painful
• Spontaneous healing 5-7
Type of wound days
1 Superficial burn 1o • Treatment:
2 Partial thickness burn 2o • Moisturizer cream
• Common analgesic
• superficial partial 2o superf
thickness
• deep partial thickness
2o deep
(full thickness)
3 Deep burn 3o
Partial thickness Partial thickness
burn burn
1. Superficial 2. Deep (full thickness)
• Epidermal layer disruption • Epidermal layer disruption
• 1/3 superficial dermal layer • 2/3 superficial dermal layer
• Blister formation • Blister formation (+/─)
• Painful • Thin eschar
• Intact dermis > • Painful
Spontaneous healing 10-14 • Intact skin appendices
days Spontaneous healing up to 21
• Treatment: days
• Moisturizer cream • Treatment:
• Blister management • Moist dressing
• Common analgesic • Blister management
• Common analgesic
2. Débridement:
Deep burn Surgical Non surgical
• Epidermal layer, dermal layer Concept changes:
and deeper layer (subcutaneous • Total excision Second place
& adipose tissue, muscles, • Tangential excision
bones) • Total excision
• Eschar Rapid Slow
• No sensation Complication: No bleeding
• Intact dermis & skin appendices Surgical bleeding complication
(─) Method:
Spontaneous healing impossible • Conventional (Humby Method:
• Treatment: knife) • Autolytic
• Debridement (escharectomy) • Electric dermatome • Enzymatic
• Skin grafting • Hydropressure
Debris removal referred to source control
The wound closure Wound healing: Review
Phases of Wound healing
• Problems encountered in burn wound closure
Homeostasis &
inflammation
Maturation
• Degree of severity
Fibroplasia
– Damaged tissue → deteriorated circulation→ non
vital tissue → inflammatory response ▲
– Burn exhaustion [metabolic changes,
inflammation]
– Prolonged phases of wound healing
• Impaired – non healing wound 0 2 4 6 8 365
Days after injury
Injury
Phase of proliferative [fibroplasias, fibro-proliferative]
Phase of Fibroplasias
• Template formation
– Proliferation of fibrin cells [collagen matrix ] replaces the
clot
• Angiogenesis
– Proliferation of endothelial cells [new vessels formation]
►Granulation tissue
• Epithelialization
– Proliferation of epithelial cells from wound edges and 1. Fibrin proliferation
skin appendices early
3. Phase of Fibroplasias
1. Fibrin proliferation
early
Phase of Fibroplasias Phase of Fibroplasias
1. Fibrin proliferation 1. Fibrin proliferation
early late
Phase of Fibroplasias Phase of Fibroplasias
1. Fibrin proliferation 2. Angiogenesis
late early
4. Phase of Fibroplasias Phase of Fibroplasias
2. Angiogenesis 2. Angiogenesis
early late
Phase of Fibroplasias Phase of Fibroplasias
Granulation: Fibrin proliferation + Angiogenesis Granulation: Fibrin proliferation + Angiogenesis
Phase of Fibroplasias Phase of Fibroplasias
Wound: contraction 3. Epithelialization
early
5. Epithelialization:
Phase of Fibroplasias Epithelization is start from the wound edges
Basal membrane
3. Epithelialization
complete
Epithelialization:
Epithelization is not always start from the wound edges
Sweat gland
Sebaseous gland
Hair follicle
Phase of remodeling [phase of maturation] Conditions of fibroplasias
• Collagen deposition [early, 2 mo]
– Indurative tissue
• Healthy granulation
• Collagen resorption [late, up to 8-12 mo] tissues
– Soften tissue – Adequate collagen
• Regression of vessels matrix
– Tissue becomes pale – Angiogenesis
►Firm and pale tissue
►Scar tissue Granulation tissue
6. Conditions of fibroplasias
• Healthy granulation
tissues
– Adequate collagen
matrix
– Angiogenesis
►excessive granulation tissue
Granulation tissue
Influencing factors
• Structural component or scaffolding
• Biologically active component stimulating all phases of
healing
• Collagen (protein)
– Scaffold for cell migration and matrix deposition
– Cell guidance
• Elastin (protein)
– Tissue elasticity
• Fibronectin (protein)
– Cell to cell adherence
– Contact orientation for cells
– Increases epithelial cell division, migration
– Chemo attractant for fibroblasts, macrophages
Influencing factors
• Growth Factors (proteins)
• Stimulate all phases of wound healing
• Glycosaminoglycan (glycosylated protein)
– Cell adherence properties
– Conduit for healing factors
– Deactivator of proteases
– Scaffold or foundation for dermal elements
• Hyaluronic Acid (complex carbohydrate)
– Maintaining matrix hydrated
– Decreases inflammation
– Stimulates healing
– Proper cell alignment
7. Temporary Skin Substitute
• Injury
SIRS and MODS Product Company
Tissue of
Origin
Layers Category Uses
How
supplied
• Inflammation
• Inadequate blood flow Temporary
Frozen in
Split coverage of
• Ischemia-reperfusion injury
Ischemia- Human Human Epidermis and rolls of
Skin bank thickness large
allograft cadaver dermis varying
• Infection skin excised
size
burns
Temporary
coverage
Brennan
Autolysis Pig dermis Dermis Dermis of partial Frozen or
Toxins Infection Healing Pig skin Medical St.
thickness refrigerated
Inflammation Xenograft Louis, Mo
and in rolls
excised
burns
Epidermis
↑ demand for ↑ demand for ↑ demand for Human On site
Placenta
Amniotic
Dermis
Same as Refrigerato
amnion procurement membrane above r
Inflammatory cells Immune modulation Mesenchymal stem cells
Room T°
Extracellular Superficial
Healthpoint Bioactive storage
Oasis® Xenograft wound matrix burns Skin
↑ demand on LTD San
from small
Dermal like
graft donor
Multiple
Marrow suppression Antonio, Tx Matrix sizes
Bone Marrow support intestine sites
3x3.5cm
submucosa Chronic
7x20cm
wounds
Marrow Exhaustion
Temporary Skin Substitute Permanent Skin Substitute
Tissue of How AVAILABLE PERMANENT SKIN SUBSTITUTES
Product Company Layers Category Uses
Origin supplied Tissue of How
Product Company Layers Category Uses
Origin supplied
Superficial
Synthetic Room T° Chronic
Dow Bilayer Synthetic partial
Biobrane® with added storage Composite wounds,
Hickam/Bertek product outer epidermis thickness Collagen matrix 7.5cm
denatured 15x20inch Organogenesis : often used
Pharmaceutica silicone Inner and dermis burns,Temp seeded with diameter
bovine 10x15cm Inc and Novartis Allogenic Epidermis with thin
ls nylon mesh orary cover Apligraf human neonatal disc
collagen 5x15inch Pharmaceuticals Composite and STSG
with added of excised keratinocytes 1/pack
5x5 inch Corp Dermis Excised
collagen burns and fibroblasts
deep burn
Superficial
Bioactive to mid- Composite
Bilayer Collagen sponge Skin graft
Smith & Dermal Partial Ortec : 6x6cm
Transcyte® Allogenic product Outer Frozen in OrCel Allogenic seeded with donor site,
Nephew Matrix thickness International Epidermis sheets
Dermis silicone Inner 5x7.5 inch Composite human neonatal chronic
Wound Components burns Inc. and
nylon seeded sheets keratinocytes wounds
Management on Synthetic Temporary Dermis
with neonatal and fibroblasts
Largo, FL dermis and coverage of
fibroblasts Deep
epidermis excised
burns partial and
50cm2
Cultured full
Genzyme Tissue Autogenous Epidermis sheets in
Epicel* autologous thickness
Repair Corp keratinocytes Only culture
keratinocytes burns
medium
>30%
TBSA
1. Used mainly in burns
Permanent Skin Substitute
AVAILABLE PERMANENT SKIN SUBSTITUTES
Tissue of How
Product Company Layers Category Uses
Origin supplied
Deep
partial and
full
A cellular
thickness
Allogenic Dermis Dermis 1x2cm to
Alloderm Life Cell burns, Soft
dermis (processed only 4x12cm
tissue
allograft)
replacemen
t, Tissue
patches
Full
The Role of Stem Cells
thickness 2x2 inch
Silicone outer soft tissue 4x10
Integra Life layer on Biosyntheti defects inch
Integra* Synthetic
Science Corp collagen GAG c Dermis definitive 8x10
dermal matrix “closure” inch
requires 5/pack
skin graft
1. Used mainly in burns
8. R. John Davenport
editor of Science’s SAGE KE
1 July 2005 Vol 309 SCIENCE www.sciencemag.org
Published by AAAS Hematopoietic and stromal stem cell differentiation
Br J Dermatol. 2005 Jul;153(1):29-36. Related
Articles, Links
Human mesenchymal stem cells
successfully improve skin-
substitute wound healing.
Nakagawa H, Akita S, Fukui M, Fujii T, Akino K.
Division of Plastic and Reconstructive Surgery, Department of
Developmental and Reconstructive Medicine, Nagasaki University,
Graduate School of Medical and Dental Sciences, 1-7-1 Sakamoto,
Nagasaki 8528501, Japan.
Plasticity of adult
stem cells
About Stem Cells Research About Stem Cells Research
• Human and Social Costs
Severe Burns
According to the Sandia National Laboratories, there are over 100,000 burn victims
annually in the U.S., receiving a total of almost one million in-hospital days spent in
Severe burns are devastating injuries, burn treatment. This represents approximately $2 billion in annual health care costs.
Potential for Stem Cell Therapies and Cures
requiring long and painful recovery, and Potential for Stem Cell Therapies and Cures
often resulting in significant scaring, Scientists have established that skin progenitor stem cellsprogenitor stem
Scientists
have established that skin (called keratinocyte
disfigurement and disability. Although cellsprogenitors) inItadult human skin haveto use embryonic stemfor growth and tissue-
(called keratinocyte progenitors) in adult human
regeneration. may also be possible
a significant capacity
cells to generate large
progress has been made with skin grafting skin numbers of healthy new epidermal or dermal skin cells.
have a significant capacity for growth and tissue- tissue-
and artificial skin technologies, scientists regeneration. Italso benefit from the stem cell therapy technique called somatic
Burn victims could may also be possible to use embryonic
believe that stem cells could provide better stem cells to generateUsing SCNT scientists can makethe original donor.
cell nuclear transfer, or SCNT.
large numbers of healthy new
“patient specific” cells, meaning the cells’ DNA matches that of
large numbers of
ways to regenerate functional skin epidermal coulddermalcommon cells. and grafts without the risk of the
Such cells or generate healthy new skin tissue
immune-rejection problems
skin to tissue organ transplants.
following burns. Information obtained from the California Research and Cures Act.
For more information on burns, visit:
• California Medical Association -- http://www.cmanet.org/
• American Nurses Association of California -- http://www.anacalifornia.org/
9. Mesenchymal Bone Marrow Stem
Cells More Effectively Stimulate
Regeneration of Deep Burn
Wounds than Embryonic
Fibroblasts
V. I. Shumakov1, N. A. Onishchenko1, M. F. Rasulov1, Structure of regenerative
M. E. Krasheninnikov1 and V. A. Zaidenov1 epidermal-dermal equivalents
based on EDC-collagen after
(1) Institute of Transplantology and Artificial Organs, Ministry of
one week (original
Health of Russian Federation, Moscow
magnification 200x, H&E
Volume 136, Number 2 / August, 2003 staining). hMSCs promote
Available in website: http://www.springerlink.com/content/1wlqwjpqleqt/ stratification ( ) and proliferation
of keratinocytes and result in a
fully differentiated multilayered
epidermis with organisation of
rete ridge-like structures ( ).
Conclusion
Structure of regenerative
epidermal-dermal equivalents The approach to skin modelling reported here
based on EDC-collagen after
one week (original
showed that non-skin-localized hMSC can
magnification 200x, H&E promote skin regeneration. The work suggests
staining). Keratinocytes
seeded alone on the collagen
that direct intercellular contact is required for a
matrix invaded into skin-specific morphology. Co-cultures of
the spongy structure ( ) and
formed only a thin, irregular
hMSCs and keratinocytes may improve the
epidermal layer. performance of composite skin grafts in clinical
applications
COLLOQUIUM PAPERS
Stem cells of the skin epithelium
Laura Alonso, and Elaine Fuchs *
Howard Hughes Medical Institute, Laboratory of Mammalian Cell Biology and Development, The
Rockefeller University, New York, NY 10021
Tissue stem cells form the cellular base for organ homeostasis and repair. Stem cells
have the unusual ability to renew themselves over the lifetime of the organ while
producing daughter cells that differentiate into one or multiple lineages. Difficult to
identify and characterize in any tissue, these cells are nonetheless hotly pursued
because they hold the potential promise of therapeutic reprogramming to grow human
tissue in vitro, for the treatment of human disease. The mammalian skin epithelium
exhibits remarkable turnover, punctuated by periods of even more rapid production
after injury due to burn or wounding. The stem cells responsible for supplying this
tissue with cellular substrate are not yet easily distinguishable from neighboring cells.
However, in recent years a significant body of work has begun to characterize the skin
epithelial stem cells, both in tissue culture and in mouse and human skin. Some
epithelial cells cultured from skin exhibit prodigious proliferative potential; in fact, for
>20 years now, cultured human skin has been used as a source of new skin to engraft
onto damaged areas of burn patients, representing one of the first therapeutic uses of
stem cells. Cell fate choices, including both self-renewal and differentiation, are crucial
biological features of stem cells that are still poorly understood. Skin epithelial stem
cells represent a ripe target for research into the fundamental mechanisms underlying
these important processes.
10. Columnar organization
of the epidermis
Cornified layers
Suprabasal layers
Basal layers
Dermis
From Gambardella and Barrandon. Curr opin cell biol 200
Ex vivo expansion of adult autologous epidermal stem cells
1-5 cm2
1 m2
Fro Howard Green and colleagues
(Rheinwald and Green, 1975. Gallico et al., N. Engl. J. Med, 1984)
Normal skin
Spontaneous healing
Epidermis generated
from transplanted
Stem cells
11. Regeneration of epidermis
•Normal keratinized epithelium
•Presence of holoclones
Regeneration of superficial
dermis
•Undulated dermo-epidermal junction
• Presence of subepidermal vascular
arcades
•Presence of elastic fibers
•Observed in fetal wound healing
•Never observed in post natal wound
healing
Absence of epidermal
appendages
•Sweat glands, sebaceous glands,
hair follicle
Why no epidermal appendages ?
1. Absence of multipotent epidermal stem cells
• No multipotent stem cells in adult skin
• Multipotent stem cells do not survive in culture
• Current culture conditions favor epidermal
differentiation
2. Absence of inductive signal(s)
The information remain scanty
• Difficulties to conduct experiment in human
– Obvious ethical reasons
– Regulatory rules (GMP)
– Cost
• Difficulties regarding patient follow up
• Poor communication between basic and medical
research laboratories
• Difficulties to assay stemness
• No control of stem cell engraftment
• Necessity of a reliable and predictable animal model