Diane Riccobono, Sabine François, Marco Valente, Fabien Forcheron and Michel Drouet
The emergence of stem cell therapy and cellular engineering during the last 10 years has allowed new therapeutic strategies to be considered for the treatment of many wound repair disorders in bones, muscles and skin. The cutaneous radiation syndrome that is often associated with radiation burn may also take advantage of these scientific advances. This syndrome, characterized by inflammatory waves, incomplete wound healing and poor revascularization is the dramatic consequence of local irradiation exposure (above 15Gy). Until the late 90’s, the treatment schedule which exhibited poor efficacy consisted in excision followed by transient coverage of the wound bed and then by autologous skin grafts. Recently the local injection of autologous bone marrow mesenchymal stem cells, which favor wound healing and reduce pain, has achieved a major advance. However this strategy hampered by culture delays and requiring non-irradiated areas to harvest stem cells remains to be optimized. Autologous or allogeneic adipose tissue-derived stem cells, easy to collect and expand, may represent a valuable therapeutic alternative especially through pro-angiogenic and anti-inflammatory properties. Other proposed strategies including stem cell manipulation to produce trophic factors (transient gene therapy), bone marrow mesenchymal stem cells or adipose tissue derived stem cells culture media injection appear as valuable alternatives. In this review we report the latest scientific progresses in pre-clinical and clinical studies concerning stem cell therapy for cutaneous radiation syndrome.