Clinical evaluation of intralesional umbilical cord‐derived mesenchymal stem cells, conditioned medium and triamcinolone acetonide injection for keloid treatment: A pilot study

Author:

Harsono Anastasia Dessy12ORCID,Dilogo Ismail Hadisoebroto34567,Prasetyono Theddeus Octavianus Hari348,Prasetyo Marcel9,Werdhani Retno Asti10,Jusman Sri Widia A.11,Siregar Nuryati Chairani12,Soedjana Hardisiswo13

Affiliation:

1. Department of Plastic and Reconstructive Surgery Gatot Subroto Army Hospital Jakarta Indonesia

2. Doctoral Program in Medical Sciences Faculty of Medicine Universitas Indonesia Jakarta Indonesia

3. ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

4. Medical Technology Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

5. Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

6. Stem Cell and Tissue Engineering Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

7. Department of Orthopaedic and Traumatology, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

8. Division of Plastic and Reconstructive Surgery, Department of Surgery, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

9. Department of Radiology, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

10. Department of Community Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

11. Department of Biochemistry and Molecular Biology, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

12. Department of Anatomical Pathology, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia

13. Department of Plastic and Reconstructive Surgery, Hasan Sadikin Hospital, Faculty of Medicine Universitas Padjadjaran Bandung Indonesia

Abstract

AbstractTopical keloid therapy is performed with triamcinolone acetonide (TA) intralesional injection. However, the recurrence rate is high with various side effects. Mesenchymal stem cells (MSCs) have high proliferative abilities and reduce the activity and proliferation of fibroblast cells in keloids. To overcome the costs and limitations, conditioned medium (CM) is used. This study aims to evaluate feasibility of intralesional injection of umbilical cord MSC (UC‐MSC) and conditioned medium (UC‐CM) compared to TA for keloid therapy. Twenty‐four patients with keloids who met the inclusion criteria were included, randomized into three treatment groups and then got assessed for the sociodemographic data, keloid volume, histopathology (type 1:3 collagen ratio), interleukin‐10 (IL‐10) levels and Patient and Observer Scar Assessment Scale (POSAS) score during visits. Largest volume regression occurred in the UC‐MSC group, followed by UC‐CM and then the TA group (UC‐MSC: 45.32% ± 2.61%; UC‐CM: 43.61% ± 3.67%; TA: 28.34% ± 3.81%; p = 0.003). Similar pattern was also observed in increase in IL‐10 levels, the decrease in POSAS scores and the reduction of type 1:3 collagen ratio. Hence, UC‐MSC and UC‐CM are promisingly more effective than TA for keloid therapy, showcasing their superiority in reducing keloid volume, symptoms and type 1:3 collagen ratio, as well as increasing the levels of IL‐10.

Funder

Direktorat Riset and Pengembangan, Universitas Indonesia

Publisher

Wiley

Subject

Dermatology,Surgery

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