The utility of dermal fibroblasts in treatment of skin disorders: A paradigm of recessive dystrophic epidermolysis bullosa
Forough Shams
Student Research Committee, Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorAzam Rahimpour
Medical Nano-Technology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorHassan Vahidnezhad
Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorSimzar Hosseinzadeh
Medical Nano-Technology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorCorresponding Author
Hamideh Moravvej
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Correspondence
Hamideh Moravvej, Skin Research Center, Shahid Beheshti University of Medical Sciences, Qods Sq., Tehran, Iran.
Email: [email protected]; [email protected]
Search for more papers by this authorBahram Kazemi
Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorMasoumeh Rajabibazl
Department of Clinical Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorFahimeh Abdollahimajd
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorJouni Uitto
Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorForough Shams
Student Research Committee, Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorAzam Rahimpour
Medical Nano-Technology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorHassan Vahidnezhad
Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorSimzar Hosseinzadeh
Medical Nano-Technology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorCorresponding Author
Hamideh Moravvej
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Correspondence
Hamideh Moravvej, Skin Research Center, Shahid Beheshti University of Medical Sciences, Qods Sq., Tehran, Iran.
Email: [email protected]; [email protected]
Search for more papers by this authorBahram Kazemi
Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorMasoumeh Rajabibazl
Department of Clinical Biochemistry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorFahimeh Abdollahimajd
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Search for more papers by this authorJouni Uitto
Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorFunding information: Shahid Beheshti University of Medical Sciences, Grant/Award Number: 1398/9773
Abstract
Dermal fibroblasts are the most accessible cells in the skin that have gained significant attention in cell therapy. Applying dermal fibroblasts' regenerative capacity can introduce new patterns to develop cell-based therapies to treat skin disorders. Dermal fibroblasts originate from mesenchymal cells and are located within the dermis. These cells are mainly responsible for synthesizing glycosaminoglycans, collagens, and components of extracellular matrix supporting skin's structural integrity. Preclinical studies suggested that allogeneic and autologous dermal fibroblasts provide widespread and beneficial applications for wound healing, burn ulcers, and inherited skin disorders. In this regard, generating induced pluripotent stem cells (iPSCs) from fibroblasts and gene-edited fibroblasts are promising approaches for treating skin disorders. Here, we aimed to review literature about ongoing and completed clinical trials that applied fibroblasts and bioengineered fibroblasts as therapeutic agents for various skin disorders. This review explores cell therapy protocols from the earliest phase of allogeneic and autologous fibroblasts development in different benches to translating them into bedside-level treatment for skin disorders, particularly recessive dystrophic epidermolysis bullosa.
Open Research
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no new data were generated in this review study.
REFERENCES
- 1Gorell E, Nguyen N, Lane A, Siprashvili Z. Gene therapy for skin diseases. Cold Spring Harb Perspect Med. 2014; 4(4): a015149.
- 2Tracy LE, Minasian RA, Caterson EJ. Extracellular matrix and dermal fibroblast function in the healing wound. Adv Wound Care. 2016; 5(3): 119-136.
- 3Uitto J, Has C, Vahidnezhad H, Youssefian L, Bruckner-Tuderman L. Molecular pathology of the basement membrane zone in heritable blistering diseases:: the paradigm of epidermolysis bullosa. Matrix Biol. 2017; 57(58): 76-85.
- 4Jacków J, Titeux M, Portier S, et al. Gene-corrected fibroblast therapy for recessive dystrophic epidermolysis bullosa using a self-inactivating COL7A1 retroviral vector. J Invest Dermatol. 2016; 136(7): 1346-1354.
- 5Wong T, Gammon L, Liu L, et al. Potential of fibroblast cell therapy for recessive dystrophic epidermolysis bullosa. J Invest Dermatol. 2008; 128(9): 2179-2189.
- 6Moravvej H, Hormozi AK, Hosseini SN, et al. Comparison of the application of allogeneic fibroblast and autologous mesh grafting with the conventional method in the treatment of third-degree burns. J Burn Care Res. 2016; 37(1): e90-95.
- 7Kumar S, Mahajan BB, Kaur S, Singh A. Autologous therapies in dermatology. J Clin Aesthet Dermatol. 2014; 7(12): 38-45.
- 8Hasegawa T, Suga Y, Mizoguchi M, et al. Clinical trial of allogeneic cultured dermal substitute for the treatment of intractable skin ulcers in 3 patients with recessive dystrophic epidermolysis bullosa. J Am Acad Dermatol. 2004; 50(5): 803-804.
- 9Golchin A, Farahany TZ. Biological products: cellular therapy and FDA approved products. Stem Cell Rev Rep. 2019; 15(2): 166-175.
- 10O'Connor NE, Mulliken JB, Bank-Schlegel S, Kehinde O, Green H. Grafting of burns with cultured epithelium prepared from autologous epidermal cells. Lancet. 1981; 1(8211): 75-78.
- 11Tang MY, Jin R, Zhang Y, et al. Advances in the research of autologous fibroblast injections for aging skin. Plast Aesthet Res. 2016; 3: 83-85.
10.20517/2347-9264.2015.118 Google Scholar
- 12Weiss RA, Weiss MA, Beasley KL, Munavalli G. Autologous cultured fibroblast injection for facial contour deformities: a prospective, placebo-controlled, phase III clinical trial. Dermatol Surg. 2007; 33(3): 263-268.
- 13Itoh M, Umegaki-Arao N, Guo Z, Liu L, Higgins CA, Christiano AM. Generation of 3D skin equivalents fully reconstituted from human induced pluripotent stem cells (ipscs). PLoS One. 2013; 8(10):e77673.
- 14Vig K, Chaudhari A, Tripathi S, et al. Advances in skin regeneration using tissue engineering. Int J Mol Sci. 2017; 18(4): 789-808.
- 15Shevchenko RV, James SL, James SE. A review of tissue-engineered skin bioconstructs available for skin reconstruction. J R Soc Interface. 2010; 7(43): 229-258.
- 16Vahidnezhad H, Youssefian L, Saeidian AH, Uitto J. Phenotypic spectrum of epidermolysis bullosa: the paradigm of syndromic versus non-syndromic skin fragility disorders. J Invest Dermatol. 2019; 139(3): 522-527.
- 17Has C, Bauer JW, Bodemer C, et al. Consensus reclassification of inherited epidermolysis bullosa and other disorders with skin fragility. Br J Dermatol. 2020; 183(4): 614-627.
- 18Van den Akker PC, Jonkman MF, Rengaw T, et al. The international dystrophic epidermolysis bullosa patient registry: an online database of dystrophic epidermolysis bullosa patients and their COL7A1 mutations. Hum Mutat. 2011; 32(10): 1100-1107.
- 19Uitto J, Vahidnezhad H. Losartan for treatment of epidermolysis bullosa: A new perspective. Dermatologic Therapy. 2021; 34(1):e14638.
- 20Woodley DT, Atha T, Huang Y, et al. Normal and gene-corrected dystrophic epidermolysis bullosa fibroblasts alone can produce type VII collagen at the basement membrane zone. J Invest Dermatol. 2003; 121(5): 1021-1028.
- 21Nagy N, Almaani N, Tanaka A, et al. HB-EGF induces COL7A1 expression in keratinocytes and fibroblasts: possible mechanism underlying allogeneic fibroblast therapy inrecessive dystrophic epidermolysis bullosa. J Invest Dermatol. 2011; 131(8): 1771-1774.
- 22Venugopal SS, Yan W, Frew JW, et al. A phase II randomized vehicle-controlled trial of allogeneic fibroblasts for recessive dystrophic epidermolysis bullosa. J Am Acad Dermatol. 2013; 69(6): 898-908.
- 23Petrof G, Martinez-Queipo M, Mellerio JE, Kemp P, McGrath JA. Fibroblast cell therapyenhances initial healing in recessive dystrophic epidermolysis bullosa wounds: results of a randomized, vehicle-controlled trial. Br J Dermatol. 2013; 169(5): 1025-1033.
- 24Lwin SW, Syed F, Di WL, et al. Safety and early efficacy outcomes for lentiviral fibroblast gene therapy in recessive dystrophic epidermolysis bullosa. JCI Insight. 2019; 4(11):e126243.
- 25Titeux M, Pendaries V, Zanta-Boussif MA, et al. SIN retroviral vectors expressing COL7A1 under human promoters for ex vivo gene therapy of recessive dystrophic epidermolysis bullosa. Mol Ther. 2010; 18(8): 1509-1518.
- 26Takahashi K, Yamanaka S. Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell. 2006; 126(4): 663-676.
- 27Tolar J, Xia L, Riddle M, et al. Induced pluripotent stem cells from individuals with recessive dystrophic epidermolysis bullosa. J Invest Dermatol. 2011; 131(4): 848-856.
- 28Sebastiano V, Zhen HH, Haddad B, et al. Human COL7A1-corrected induced pluripotent stem cells for the treatment of recessive dystrophic epidermolysis bullosa. Sci Transl Med. 2014; 6(264): 264ra163.
- 29Spiliopoulos S, Davanos N. Induced pluripotent stem cells for the treatment of recessive dystrophic epidermolysis bullosa. Ann Transl Med. 2015; 3(22): 349.
- 30Osborn M, Starker CG, McElroy AN, et al. TALEN-based gene correction for epidermolysis bullosa. Mol Ther. 2013; 21: 1151-1159.
- 31Webber BR, Osborn MJ, McElroy AN, et al. CRISPR/Cas9-based genetic correction for recessive dystrophic epidermolysis bullosa. NPJ Regen Med. 2016; 1: 16014.
- 32Moravvej H, Abdollahimajd F, Naseh MH, et al. Cultured allogeneic fibroblast injection vs. fibroblasts cultured on amniotic membrane scaffold for dystrophic epidermolysis bullosa treatment. Br J Dermatol. 2018; 179(1): 72-79.
- 33Hasegawa T, Suga Y, Mizoguchi M, et al. Intractable venous leg ulcer treated successfully with allogeneic cultured dermal substitute. Scand J Plast Reconstr Surg Hand Surg. 2007; 41(6): 326-328.
- 34Moroi Y, Fujita S, Fukagawa S, et al. Clinical evaluation of allogeneic cultured dermal substitutes for intractable skin ulcers after tumor resection. Eur J Dermatol. 2004; 14(3): 172-176.
- 35Kubanova A, Karamova A, Albanova V, et al. Allogeneic fibroblast cell therapy in the treatment of recessive dystrophic epidermolysis bullosa. Wound Med. 2018; 21: 8-11.
10.1016/j.wndm.2018.04.002 Google Scholar
- 36Nishimoto J, Amoh Y, Tanabe K, Niiyama N, Katsuoka K, Kuroyanagi Y. Intractable leg ulcers associated with antiphospholipid syndrome with stasis dermatitis: treatment with allogeneic cultured dermal substitute. Eur J Dermatol. 2007; 17(4): 350-351.
- 37Yamada N, Uchinuma E, Kuroyanagi Y. Clinical trial of allogeneic cultured dermal substitutes for intractable skin ulcers of the lower leg. J Artif Organs. 2008; 11(2): 100-103.
- 38Nilforoushzadeh MA, Siadat AH, Arianrad M, Moulavi F, Baradaran EH, Esfahani MH. Soft tissue augmentation by autologous cultured fibroblasts transplantation for treatment of wrinkles and scars: a case series of 20 patients. J Res Med Sci. 2010; 15(3): 167-171.
- 39Smith SR, Munavalli G, Weiss R, Maslowski JM, Hennegan KP, Novak JM. A multicenter, double-blind, placebo-controlled trial of autologous fibroblast therapy for the treatment of nasolabial fold wrinkles. Dermatol Surg. 2012; 38(7): 1234-1243.
- 40Morimoto N, Ito T, Takemoto S, et al. An exploratory clinical study on the safety and efficacy of an autologous fibroblast-seeded artificial skin cultured with animal product-free medium in patients with diabetic foot ulcers. Int Wound J. 2014; 11(2): 183-189.
- 41Eca LP, Pinto DG, de Pinho AM, Mazzetti MP, Odo ME. Autologous fibroblast culture in the repair of aging skin. Dermatol Surg. 2012; 38(2): 180-184.
- 42Watson D, Keller GS, Lacombe V, Fodor PB, Rawnsley J, Lask GP. Autologous fibroblasts for treatment of facial rhytids and dermal depressions. A pilot study. Arch Facial Plast Surg. 1999; 1(3): 165-170.
- 43Caravaggi C, De Giglio R, Pritelli C, et al. HYAFF 11-based autologous dermal and epidermal grafts in the treatment of noninfected diabetic plantar and dorsal foot ulcers: a prospective, multicenter, controlled, randomized clinical trial. Diabetes Care. 2003; 26(10): 2853-2859.
- 44Limova M. Active wound coverings: bioengineered skin and dermal substitutes. Surg Clin North Am. 2010; 90(6): 1237-1255.
- 45Varkey M, Ding J, Tredget EE. Advances in skin substitutes-potential of tissue engineered skin for facilitating anti-fibrotic healing. J Funct Biomater. 2015; 6(3): 547-563.
- 46Ng KW, Hutmacher DW. Reduced contraction of skin equivalent engineered using cell sheets cultured in 3D matrices. Biomaterials. 2006; 27(26): 4591-4598.
- 47Venugopal JR, Zhang Y, Ramakrishna S. In vitro culture of human dermal fibroblasts on electrospun polycaprolactone collagen nanofibrous membrane. Artif Organs. 2006; 30(6): 440-446.
- 48van Dorp AG, Verhoeven MC, Koerten HK, van Blitterswijk CA, Ponec M. Bilayered biodegradable poly(ethylene glycol)/poly(butylene terephthalate) copolymer (polyactive) as substrate for human fibroblasts and keratinocytes. J Biomed Mater Res. 1999; 47(3): 292-300.
10.1002/(SICI)1097-4636(19991205)47:3<292::AID-JBM2>3.0.CO;2-B PubMed Web of Science® Google Scholar
- 49Dodson BP, Levine AD. Challenges in the translation and commercialization of cell therapies. BMC Biotechnol. 2015; 15(70).
- 50Ackermann K, Borgia SL, Korting HC, Mewes KR, Schafer-Korting M. The phenion full-thickness skin model for percutaneous absorption testing. Skin Pharmacol Physiol. 2010; 23(2): 105-112.