Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (7): 1699-1710.doi: 10.12307/2026.582

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

He Jiale1, 2, Huang Xi2, Dong Hongfei2, Chen Lang1, Zhong Fangyu1, Li Xianhui1, 2   

  1. 1School of Clinical Medicine, North Sichuan Medical College, Nanchong 637002, Sichuan Province, China; 2Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
  • Received:2024-10-17 Revised:2025-04-30 Accepted:2025-05-29 Online:2026-03-08 Published:2025-08-19
  • Contact: Li Xianhui, PhD, Associate professor, School of Clinical Medicine, North Sichuan Medical College, Nanchong 637002, Sichuan Province, China; Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
  • About author:He Jiale, Master candidate, School of Clinical Medicine, North Sichuan Medical College, Nanchong 637002, Sichuan Province, China; Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China Huang Xi, Attending physician, Department of Burn and Plastic Surgery, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China He Jiale and Huang Xi contributed equally to this article.
  • Supported by:
    Incubation Project of Hospital Management Project of General Hospital of Western Theater Command, No. 2021-XZYG-C36 (to HX)

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 

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