Combined Adipose Mesenchymal Stromal Cell Advanced Therapy Resolved A Recalcitrant Leg Ulcer In An 85-Year-Old Patient

Venous leg ulcers (VLU) represent an uphill economic, health and social burden, aggravated in the elderly. Best-practice care interventions are often insufficient and alternative therapies need to be explored. Herein, we have treated for the first time a chronic VLU in an elderly patient by combining cell therapy and tissue engineering in the context of a compassionate use. The administration of allogeneic adipose-derived mesenchymal stromal cells (MSCs) embedded in a plasma-based bioengineered dermis covering the ulcer bed and also injected into the ulcer margins led to the complete closure of a 10-year recalcitrant VLU in an 85-year-old patient. Regenerative properties of MSCs might be boosted by the use of bioengineered matrices for their delivery.Lay abstractElderly people suffering from leg ulcers often have a reduced quality of life for a number of reasons. These include persistent pain, difficulty moving, depression and social isolation. They also need to visit special health facilities regularly for dressing changes, which can be expensive and often does not help them much. In this paper, we have described how we treated an 85-year old patient's leg ulcer that has not healed in the past 10 years. We treated the patient with cells called mesenchymal stromal cells (MSCs) that we took from the fat of a young healthy donor. In the past, MSCs have been shown to be capable of temporarily improving wound healing without being rejected by the body. To increase the effect of this treatment, researchers are trying to develop ways of keeping living MSCs in place at the injured site after they have been given to the patient. To do this, we therefore combined two different methods of applying the MSCs to the patient's leg ulcer. We both injected them around the ulcer edge and added them to an artificial dermis layer that covered the whole ulcer. We found that this technique successfully healed the ulcer of our patient, probably because each method boosted the other. The quality of life of the patient was therefore improved since their movement improved and pain disappeared after the treatment.