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Comparative efficacy of topical Adipocyte-derived Mesenchymal Stem Cells-Conditioned Medium (ADMSC-CM) and Amniotic Membrane Mesenchymal Stem Cells-Conditioned Medium (AMSC-CM) on chronic plantar ulcers in leprosy: a randomized controlled trial

  • Medhi Denisa Alinda ,
  • Paulus Mario Christopher ,
  • Muhammad Yulianto Listiawan ,
  • Anang Endaryanto ,
  • Heri Suroto ,
  • Fedik Abdul Rantam ,
  • Esti Hendradi ,
  • Hari Basuki Notobroto ,
  • Sri Linuwih Susetyo Wardhani Menaldi ,
  • Cita Rosita Sigit Prakoeswa ,


Abstract

Introduction: Chronic Plantar Ulcer of Leprosy (CPUL), one of the debilitating disabilities and complications, poses a treatment challenge. Utilization of stem cells, specifically adipocyte-derived mesenchymal stem cells-conditioned medium (ADMSC-CM) and amniotic membrane mesenchymal stem cells-conditioned medium (AMSC-CM), may serve as a novel therapeutic option. This study aims to compare the efficacy of topical ADMSC-CM, topical AMSC-CM, and farmazertin gauze dressing (FGD) only on the healing of CPUL.

Methods: In this randomized controlled trial, our study recruited 54 subjects with CPUL. Subjects were randomly assigned to topical ADMSC-CM (n = 16), topical AMSC-CM (n = 22), or FGD (n = 16) applied every three days for up to 8 weeks. Data were analyzed using SPSS version 20 for Windows.

Results: Healing percentage increased each week in all groups. Statistic differences between groups (p <0.05) were observed for ulcer mean size and depth reduction from week three onwards. No adverse reactions or complications were reported. At the end of the study, based on clinically improved ulcers, topical ADMSC-CM (100.0%) were superior in improving the healing of CPULs compared to topical AMSC-CM (54.55%) and FGD only (50.0%).

Conclusion: ADMSC-CM and AMSC-CM are potential therapeutic agents in the management of CPUL, with ADMSC-CM being superior in overall ulcer improvement.

Keywords: ADMSC-CM AMSC-CM CPUL Tropical Disease Leprosy

References

  1. Chaptini C, Marshman G. Leprosy: a review on elimination, reducing the disease burden, and future research. Lepr Rev. 2015;86(4):307-315.
  2. Walker SL, Lockwood DN. Leprosy. Clin Dermatol. 2007;25(2):165-172. doi:
  3. Listiawan MY. Comparison of TLR2/1, NF-?B p105/50, NF-?B p65, and TNF-? expressions in the macrophages between multibacillary leprosy patients with and without erythema nodosum leprosum signifying innate immune system activity. Bali Medical Journal. 2019;8(1):347-353.
  4. Raziyeva K, Kim Y, Zharkinbekov Z, Kassymbek K, Jimi S, Saparov A. Immunology of Acute and Chronic Wound Healing. Biomolecules. 2021;11(5):700.
  5. Guo S, Dipietro LA. Factors affecting wound healing. J Dent Res. 2010;89(3):219-229.
  6. Martin P, Nunan R. Cellular and molecular mechanisms of repair in acute and chronic wound healing. Br J Dermatol. 2015;173(2):370-378.
  7. Bai X. Stem Cell-Based Disease Modeling and Cell Therapy. Cells. 2020;9(10):2193.
  8. Francis E, Kearney L, Clover J. The effects of stem cells on burn wounds: a review. Int J Burns Trauma. 2019;9(1):1-12.
  9. Prakoeswa CRS, Natallya FR, Harnindya D, Thohiroh A, Oktaviyanti RN, Pratiwi KD, et al. The efficacy of topical human amniotic membrane-mesenchymal stem cell-conditioned medium (hAMMSC-CM) and a mixture of topical hAMMSC-CM + vitamin C and hAMMSC-CM + vitamin E on chronic plantar ulcers in leprosy:a randomized control trial. J Dermatolog Treat. 2018;29(8):835-840.
  10. Reckhenrich AK, Kirsch BM, Wahl EA, Schenck TL, Rezaeian F, Harder Y, et al. Surgical sutures filled with adipose-derived stem cells promote wound healing. PLoS One. 2014;9(3):e91169.
  11. Martin-Piedra MA, Alfonso-Rodriguez CA, Zapater A, Durand-Herrera D, Chato-Astrain J, Campos F, et al. Effective use of mesenchymal stem cells in human skin substitutes generated by tissue engineering. Eur Cell Mater. 2019;37:233-249.
  12. Natallya FR, Herwanto N, Prakoeswa C, Indramaya DM, Rantam FA. Effective Healing of Leprosy Chronic Plantar Ulcers by Application of Human Amniotic Membrane Stem Cell Secretome Gel. Indian J Dermatol. 2019;64(3):250. do
  13. Abbade LPF, Frade MAC, Pegas JRP, Dadalti-Granja P, Garcia LC, Bueno Filho R, et al. Consensus on the diagnosis and management of chronic leg ulcers - Brazilian Society of Dermatology. An Bras Dermatol. 2020;95 Suppl 1(Suppl 1):1-18.
  14. Barzegar M, Kaur G, Gavins FNE, Wang Y, Boyer CJ, Alexander JS. Potential therapeutic roles of stem cells in ischemia-reperfusion injury. Stem Cell Res. 2019;37:101421.
  15. Vériter S, André W, Aouassar N, Poirel HA, Lafosse A, Docquier PL, et al. Human Adipose-Derived Mesenchymal Stem Cells in Cell Therapy: Safety and Feasibility in Different "Hospital Exemption" Clinical Applications. PLoS One. 2015;10(10):e0139566.
  16. Kim BS, Debye B, Beier JP. Adipose-derived stem cells in cutaneous wound repair. Plast Aesthet Res. 2018;5:31.
  17. Hu C, Zhao L, Li L. Current understanding of adipose-derived mesenchymal stem cell-based therapies in liver diseases. Stem Cell Res Ther. 2019;10(1):199.
  18. Li X, Xie X, Lian W, Shi R, Han S, Zhang H, Lu L, Li M. Exosomes from adipose-derived stem cells overexpressing Nrf2 accelerate cutaneous wound healing by promoting vascularization in a diabetic foot ulcer rat model. Exp Mol Med. 2018;50(4):1-14.
  19. Weiliang Z, Lili G. Research Advances in the Application of Adipose-Derived Stem Cells Derived Exosomes in Cutaneous Wound Healing. Ann Dermatol. 2021;33(4):309-317.
  20. Yang T, Zhao F, Zhou L, Liu J, Xu L, Dou Q, et al. Therapeutic potential of adipose-derived mesenchymal stem cell exosomes in tissue-engineered bladders. J Tissue Eng. 2021;12:20417314211001545.
  21. Ellis S, Lin EJ, Tartar D. Immunology of Wound Healing. Curr Dermatol Rep. 2018;7(4):350-358.
  22. Wang L, Hu L, Zhou X, Xiong Z, Zhang C, Shehada HMA, Hu B, Song J, Chen L. Exosomes secreted by human adipose mesenchymal stem cells promote scarless cutaneous repair by regulating extracellular matrix remodelling. Sci Rep. 2017;7(1):13321.
  23. Ilic D, Vicovac L, Nikolic M, Lazic Ilic E. Human amniotic membrane grafts in therapy of chronic non-healing wounds. Br Med Bull. 2016;117(1):59-67.
  24. Miki T. Stem cell characteristics and the therapeutic potential of amniotic epithelial cells. Am J Reprod Immunol. 2018;80(4):e13003.
  25. Farhadihosseinabadi B, Farahani M, Tayebi T, Jafari A, Biniazan F, Modaresifar K, et al. Amniotic membrane and its epithelial and mesenchymal stem cells as an appropriate source for skin tissue engineering and regenerative medicine. Artif Cells Nanomed Biotechnol. 2018;46(sup2):431-440.
  26. Wassmer CH, Berishvili E. Immunomodulatory Properties of Amniotic Membrane Derivatives and Their Potential in Regenerative Medicine. Curr Diab Rep. 2020;20(8):31.
  27. Jiang LW, Chen H, Lu H. Using human epithelial amnion cells in human de-epidermized dermis for skin regeneration. J Dermatol Sci. 2016;81(1):26-34.
  28. Puri V, Venkateshwaran N, Khare N. Trophic ulcers-Practical management guidelines. Indian J Plast Surg. 2012;45(2):340-351.

How to Cite

Alinda, M. D., Christopher, P. M., Listiawan, M. Y., Endaryanto, A., Suroto, H., Rantam, F. A., Hendradi, E., Notobroto, H. B., Menaldi, S. L. S. W., & Prakoeswa, C. R. S. (2021). Comparative efficacy of topical Adipocyte-derived Mesenchymal Stem Cells-Conditioned Medium (ADMSC-CM) and Amniotic Membrane Mesenchymal Stem Cells-Conditioned Medium (AMSC-CM) on chronic plantar ulcers in leprosy: a randomized controlled trial. Bali Medical Journal, 10(3), 958–963. https://doi.org/10.15562/bmj.v10i3.2747
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Medhi Denisa Alinda
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Paulus Mario Christopher
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Muhammad Yulianto Listiawan
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Anang Endaryanto
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Heri Suroto
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Fedik Abdul Rantam
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Esti Hendradi
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Hari Basuki Notobroto
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Sri Linuwih Susetyo Wardhani Menaldi
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Cita Rosita Sigit Prakoeswa
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