Acellular dermal matrix combined with adipose-derived stem cell exosomes promotes burn wound healing

doi:10.12307/2026.582

Abstract

Abstract: BACKGROUND: Both acellular dermal matrix and adipose mesenchymal stem cell exosomes can promote wound repair, but whether the combination of the two has therapeutic effect on burn wounds is still lacking.
OBJECTIVE: To investigate the promoting effect of acellular dermal matrix combined with adipose mesenchymal stem cell exosomes on wound healing of deep second-degree burn.
METHODS: 40 SD rats were selected to make deep second-degree burn wounds and randomly divided into control group, acellular dermal matrix group, adipose mesenchymal stem cell exosome group, and acellular dermal matrix + adipose mesenchymal stem cell exosome group (hereinafter referred to as the combined group), with 10 rats in each group. After treatment, the wound healing was observed. Histopathological observation and immunohistochemical staining were performed on the wound tissue at 2, 8, and 14 days after treatment. Apoptosis was observed by immunofluorescence staining and TUNEL staining at 2 days after treatment.
RESULTS AND CONCLUSION: (1) After 14 days of treatment, the wound healing rate and healing area of combined group were higher than those of other three groups (P < 0.05). (2) Hematoxylin-eosin staining showed that compared with the other three groups, the wound epithelization was more complete and the collagen fibers were arranged more neatly in the combined group. Masson staining showed that compared with the other three groups, the collagen fiber content in the combined group was increased (P < 0.01). (3) Immunohistochemistry showed that the expression of pro-inflammatory factors in the combined group was lower than that in the other three groups (P < 0.01). The expression of anti-inflammatory factor was higher than that of the other three groups
(P < 0.01). The number of new blood vessels in the combined group was higher than that in the other three groups (P < 0.01). (4) Immunofluorescence showed that the average fluorescence intensity of BAX and Caspase-3 in the combined group was lower than that in the other three groups (P < 0.01). The average fluorescence intensity of BCL-2 was higher than that of the other three groups (P < 0.01). (5) TUNEL staining showed that the apoptosis index of the combined group was lower than that of the other three groups (P < 0.01). The results showed that combined therapy could promote the regeneration of collagen fibers, inhibit inflammation and apoptosis, and accelerate the healing of burn wounds.

Key words: acellular dermal matrix, adipose-derived mesenchymal stem cell, exosome, burn, skin, inflammation, apoptosis, wound healing

CLC Number:

He Jiale, Huang Xi, Dong Hongfei, Chen Lang, Zhong Fangyu, Li Xianhui. Acellular dermal matrix combined with adipose-derived stem cell exosomes promotes burn wound healing [J]. Chinese Journal of Tissue Engineering Research, 2026, 30(7): 1699-1710.

Figures/Tables 9

2.4 治疗后不同时间点各组大鼠创面组织学观察结果见图4。治疗后2 d，各组大鼠创面组织均出现表皮层细胞核固缩，真皮层胶原纤维破裂、融合，可见坏死的皮肤附属器。治疗后8 d，对照组坏死的胶原纤维出现断裂，断裂处以下可见部分再生的胶原纤维；ADM组与ADSC-Exo组坏死胶原纤维断裂处可见不连续的部分新生表皮层，下方可见有较多疏松的胶原纤维再生；ADM+ADSC-Exo组可见连续的表皮层，且颜色明显深于其他3组，表皮层下可见大量再生的胶原纤维，并可见新生的少量皮肤附属器。治疗后14 d，ADM+ADSC-Exo组表皮层更为完整、连续，并与真皮层贴合度更高，胶原纤维粗大，排列有序，皮肤附属器完整，新生组织覆盖范围大于其他3组；其他3组可见不同程度的炎症细胞浸润，胶原纤维相对细小并杂乱；ADM+ADSC-Exo组皮肤组织及形态最接近于正常皮肤。 2.5 不同治疗时间点各组大鼠Masson染色观察结果见图5。治疗后2 d，各组大鼠创面胶原纤维均坏死、融合，排列紊乱。治疗后8 d，对照组创面组织下方可见疏松的再生胶原纤维，以及少量坏死的皮肤附属器，还未生成表皮层；ADM组与ADSC-Exo组可见不连续的表皮层再生，以及大量再生的胶原纤维，其中ADM组胶原纤维颜色深于ADSC-Exo组，而ADM+ADSC-Exo组胶原纤维颜色比他3组更深，可见部分再生的皮肤附属器。治疗后14 d，ADM+ADSC-Exo组相较其他3组，胶原纤维为深蓝色且分布更为均匀，胶原纤维粗大、排列整齐有序、间隙清晰；ADM+ADSC-Exo组胶原纤维结构及含量最接近正常皮肤组织，而其他3组胶原纤维排列相对紊乱，细胞浸润及组织空泡较多。对正常皮肤组织及治疗后14 d创面组织通过Image J定量分析胶原纤维含量，结果显示：正常皮肤胶原纤维含量均高于ADM+ADSC-Exo组、ADSC-Exo组、ADM组及对照组，其中ADM+ADSC-Exo组创面新生组织中胶原纤维含量显著高于另外3组(P < 0.01)，最接近正常皮肤。而ADSC-Exo组与ADM组创面新生组织中胶原纤维含量均高于对照组(P < 0.01)。 "

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