Resolution of a Bedsore Mediated through Exosomes from ADSC of Allogenic Fat: First Observational Case Report

This is a first observational case report defining the resolution of a bedsore mediated through Exosomes from ADSC of Allogenic Fat. A very widespread use of autologous fat transplant is a common procedure, and it is a well-known way to treat bad healing wounds and to fill area of tissue loss. Fat is harvested from patient as autologous fat. The use of exosomes, microvesicles not carrying deoxyribonucleic acid (other than very little portion of DNA whose importance is not clear) but miRNA, could be a new frontier and foresee new therapy scenarios because of their possible use even from homologous origin. Exosomes are membrane-bound extracellular vesicles that are produced in the endosomal compartment of most eukaryotic cells and can transfer molecules from one cell to another, thereby influencing the immune system and may play a functional role in mediating adaptative immune response to pathogens and tumors. An extraordinary explosion of interest is being addressed to exosomes for many reasons. Mainly, they are thought to provide a means of intercellular communication and of transmission of macromolecules between cells. Second, they have been proposed to be useful vectors for drugs because they are composed of cell membranes, rather than synthetic polymers, and are better tolerated by the host. Chronic wound healing is a challenging medical problem, which urgently requires anatomical and functional solutions. Adipose-derived stem cells (ADSC) are mesenchymal stem cells with self-renewal and multiple differentiation ability and play essential roles in wound healing and tissue regeneration. Exosomes from ADSC are extracellular vesicles essential for communication between cells. Exosomes from ADSC can restore tissue homeostasis and accelerate wound healing by promoting various stage of wound repair, including regulating the inflammatory response, promoting wound angiogenesis, accelerating cell proliferation and modulating wound remodeling. Compared with ADSC, exosomes have the advantage of avoiding medical issues, being easily stored and having high stability. Following an admission to an intensive care unit ward, in January 2014, the patient A.A., a woman suffering from ALS and definitely lying in bed, did not receive any mobilization. I had the opportunity to treat her bedsore with exosomes from ADSC of her husband, achieving a resolution in few days after some months of unsuccessful traditional plastic surgery care.

Specific guidelines on the use of microvesicles from homologous origin, that a peer to peer commission and a consensus conference would be set up, will have to be defined in order to avoid every attempt to forward a “Miracle Therapy” and every “Pirate Business”, but also to deliver to clinical use a safe and clever way to treat wounds.