Table 1 Different cell types used for tissue-engineered skin substitutes (TESSs) considering clinical studies.
Human cell type used for TESSs | Ease of isolation | Possibility to differentiate into different cell types | Time required to treat patients | Possibility of immune rejection | Proven Safety | Ethical issues | Proven effectiveness | |
|---|---|---|---|---|---|---|---|---|
Human adult skin cells | Keratinocytes | -One or two skin biopsies (3–9 cm2) -Specific conditions for culture (feeder layers or commercial media) | No | Autologous use: 7–95 days | No | Yes | No | Yes, although with limitations |
Allogeneic use: 0–24 days | Yes | No | Yes | More clinical studies are required | ||||
Fibroblasts | -One or two skin biopsies (3–9 cm2) | No | Autologous use: 7–95 days | No | Yes | No | Yes, although with limitations | |
Allogeneic use: 0–24 days | Yes | Yes | Yes | Before the development of composite skin substitutes were extensively used | ||||
Melanocytes | -One or two skin biopsies (3–9 cm2) -Specific conditions for culture (commercial media) -Difficult to isolate | No | Autologous use: 30–95 days | No | No (risk of cancer) | No | More clinical studies are required | |
Langerhans cells and Merkel cells | -Skin biopsies -Difficult to isolate | No | – | – | – | No | Non-clinical studies using these cells for wound healing | |
Human stem cells | Skin stem cells | -Skin biopsies -Difficult to isolate | Yes (in vitro and in vivo) | – | – | – | Yes Proliferative capacity of stem cells | Non-clinical studies using these cells for wound healing |
Induced pluripotent stem cells | -Any human adult cell | Yes (in vitro and in vivo) | – | – | – | Yes Proliferative capacity of stem cells Genetic manipulation | Non-clinical studies using these cells for wound healing | |
Mesenchymal stem cells | -Bone marrow: iliac crest injection -Wharton’s Jelly: umbilical cord sample -Adipose tissue: adipose tissue biopsy or liposuction | Yes (in vitro and in vivo) | 0–28 days | No for autologous source Yes, for allogeneic source. Although due to their immunomodulatory properties risk is reduce | Yes | Yes Proliferative capacity of stem cells Although they have been used (autologous or allogeneic source) for other diseases | More clinical studies are required |
