Human skin tissue is the initial line of defense against external stimuli attempting to enter the body. It serves an important role in preserving an ongoing level of internal homeostasis. Divided into the epidermis, dermis, and hypodermis, each layer conducts a specific function crucial to the maintenance of ongoing bodily function.
Keratinocytes constitute 95 % of the total composition of skin tissue, making them the primary cell type within the epidermal layer. Their durable structure and tight junctions create a robust boundary to external threats to the body. They also conduct numerous important immune functions, like producing pro-inflammatory mediators that attract leukocytes to the site of pathogen invasion.
Keratinocytes are a key resource in the evaluation of potentially harmful components present within newly developed dermal treatments (Choi and Lee, 2015). As they dominate the epidermal layer, keratinocytes serve as a primary indicator of negative or positive reactions to potential treatments and applications.
Melanocytes are an additional vital cell type, and they are found within the lower layer of the epidermis (comprising 5-10 % of all cells found there). Melanin is responsible for the skin’s pigment and protects the lower layers of tissue from UV-B radiation.
Fibroblasts are predominately found within the hypodermis. They secrete precursors that help form the materials required to create the extracellular matrix. This matrix maintains the structural integrity of tissues throughout the body.
Like keratinocytes, fibroblasts conduct an important immunological role and contribute to wound healing. In addition to inducing an inflammatory response, they create collagen for wound closure and reparation of damaged tissue.
Vitiligo is a relatively common skin disease that affects up to 2 % of the general population (Latheef et al., 2017). It is typically characterized by demarcated patches of white skin that develop because of the loss of melanocytes within the tissue (Latheef et al., 2017).
Various factors can cause the development of vitiligo. It is therefore difficult to create a universal treatment for the disease. However, current research is investigating whether vitiligo can be treated by transplanting autologous melanocyte-keratinocyte cultures, which would act to replenish cells in the target region that had previously disappeared (Latheef et al., 2017).
A hundred patients with focal stable vitiligo (defined as no increase within a minimum of one-year minimum) were treated by first isolating a suspension of keratinocyte and melanocyte cells from healthy epidermal tissue obtained from a non-lesioned portion of the body (Latheef et al., 2017).
Recipient treatment areas (the vitiligo lesion) were subsequently abraded with a high-speed dermabrader and treated with the autologous melanocyte-keratinocyte culture (Latheef et al., 2017). Treated areas were monitored frequently for five years, and photographs were taken at every patient visit (Latheef et al., 2017).
After five years, 44 % of patients experienced an “excellent” reaction to treatment, with pigmentation in the lesioned areas restoring to levels of 90-100 % of those seen within normal/healthy tissues (Latheef et al., 2017).
Of the 100 patients treated, 90 % exhibited a marked increase in pigmentation within the areas that received the melanocyte-keratinocyte transplant (Latheef et al., 2017).
While additional studies are required to accommodate a larger number of recipients, these primary results demonstrate the strong potential of autologous cell transplantation as a viable treatment method for vitiligo.
The use of donor-derived fibroblasts for the treatment of aging skin and dermal defects is another important area of research (Tang et al., 2015). Numerous cosmetic therapies for facial imperfections aim to rectify issues through treatments that provide immediate and visible results, including Botox injections and dermal filler.
However, these techniques often yield temporary results and continuous treatment is required for maintenance.
The injection of autologous cultured fibroblasts for treating cosmetic deficiencies has been used since 1995 (Boss et al., 2000).
The results from this method are not immediately on the surface, and a few continuous treatments are typically needed. However, the introduction of living cells into the problem areas helps restore a lot of the skin’s integral structural functionality and can maintain greater maintenance than more traditional treatments.
These therapies also have additional applications in correcting other skin deformities, such as acne irregularities, atrophy, wounds, and scars (Tang et al., 2015).
As the fibroblasts utilized for treatment are often obtained from the donor, the possibility of adverse reactions is substantially lower than other alternatives, such as dermal fillers and Botox (Tang et al., 2015).
The expansion of research into skin-derived primary cells has many implications for future innovations and treatments that aim to correct numerous dermatological conditions.
By further increasing the availability and applications for these cell lines in the industry, scientists will be more equipped to efficiently treat patients with a lower possibility of an adverse reaction.
References and further reading
Boss Jr, W.K., Usal, H., Fodor, P.B., Chernoff, G. (2000). Autologous cultured fibroblasts: A protein repair system. Annals of Plastic Surgery, 44, 536-542.
Choi, M. and Lee, C. (2015). Immortalization of primary keratinocytes and its application to skin research. Biomolecules & Therapeutics, 23(5), 391-399.
Latheef, E.N.A., Muhammed, K., Riyaz, N. and Binitha, M.P. (2017). A retrospective study of 100 cases of focal vitiligo treated by autologous, noncultured melanocyte-keratinocyte cell transplantation. International Journal of Research in Dermatology, 3(1), 33-36.
Tang, MY., Jin, R., Zhang, Y., Shy, YM., Sun, BS., Zhang, L., and Zhang, YG. (2015). Plastic and Aesthetic Research, 3, 83-85.
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