Trotz adäquater Behandlung eines Ulcus cruris venosum kann es zu therapierefraktären
Verläufen kommen, in denen das Ulkus über einen längeren Zeitraum, manchmal über Jahre,
nicht abheilt. Eine Behandlung mit mesenchymalen Stammzellen kann dazu beitragen,
die persistierende Entzündung zu kontrollieren, die gestörte Gewebehomöostase wiederherzustellen
und die Wiederaufnahme der physiologischen Wundheilung zu ermöglichen.
Abstract
Chronic venous leg ulcers (CVUs) are the most serious consequence of chronic venous
insufficiency in the legs. Even with appropriate treatment, ulcers can become refractory
and remain unhealed for long periods of time, sometimes years. Non-healing CVUs are
characterized by persistent inflammation dominated by uncontrolled recruitment and
activation of pro-inflammatory M1 macrophages, creating a pro-oxidative microenvironment
that damages tissue and stalls the wound healing process in the inflammatory phase.
When guideline-directed causal and local therapies have been exhausted, treatment
with mesenchymal stem cells is a practical and reimbursable option available in Germany
for the treatment of refractory CVUs. The cells are applied once to the wound prepared
by surgical debridement. Due to the immunomodulatory properties of mesenchymal stem
cells, such treatment may help to limit inflammation, restore impaired tissue homeostasis,
and allow the ulcer to enter the proliferative and remodeling phases of wound healing.
Schlüsselwörter
mesenchymale Stammzellen - Stammzelltherapie - Ulcus cruris venosum - Wundheilung
Keywords
mesenchymal stem cells - stem cell therapy - venous leg ulcer - wound healing
