Revolutionary study makes skin tissue grow to heal wounds

TOKYO – In a world first, researchers have turned tissue cells into skin cells to help heal serious wounds, a technique that could revolutionize care for burn victims and other serious injuries.

The research is the culmination of a decade of work and is promising for a variety of patients, including those with severe burns or elderly patients with pressure ulcers and other recurrent lesions. . The study, published Thursday in the journal Nature, involves a technology called cell reprogramming in which genes are inserted into the cells to change them from one form to the other.

"This is the first description of reprogramming tissue cells into skin cells," AFP senior author Masakazu Kurita told AFP.
"I'm really excited about the results."

Kurita, a plastic surgeon and professor at Tokyo University, began working on the technique 10 years ago. This process has been laborious and laborious.

The first step was to identify the genes in the skin cells, but not in the tissue cells, which could be isolated and inserted into the tissue cells for processing. "We selected about 80 candidate genes from the skin cells, and then tried combinations," Kurita said.

His breakthrough came in 2014, when he successfully reprogrammed tissue cells into skin cells in a culture dish using a combination of 28 genes. In 2015, he joined the Salk Institute for Biological Studies in California to collaborate with a team of specialists from around the world. In total, he and his colleagues conducted approximately 2,000 trials with different gene combinations, looking for the most efficient way to transform cells. Finally, they obtained a combination of four genes and began testing it on wounds in mice.

They sealed the wounds of the surrounding skin to reproduce the harsh conditions at the center of a large burn or similar injury, with no adjacent skin to promote healing. Thanks to this technology and existing drug treatments, they have been able to heal an injury of one centimeter in diameter in about two weeks.

A way to survive

"Our data suggest the feasibility of a completely new therapy that could be used for closing wounds of different causes," Kurita said. The most obvious application would be severe burns covering large areas of the body, which are usually treated with skin grafts, he added.

"When areas affected by burns are extremely extensive and no skin is available for patients, no one can offer the patient a way to survive … our technique could offer a way." But he warned that research was still far from available to patients, with perhaps another decade of work before that date.

He wants to see research on better ways to provide the combination of four genes that turns the tissue into skin. For the study, the researchers used a virus that was used in other cells transforming the work as a delivery system for the combination of four genes. But future research could develop a potentially more efficient distribution system, specifically designed for their technique.

Kurita said more work could be done on the types of drugs used to support healing. This study used combinations of existing drugs, but "if we could make other combinations, other drugs, everything would be optimized exclusively for our purpose".

"Probably the effectiveness could be much better and shorten the healing time." There are also risks to consider. The study monitored newly transformed skin cells in test mice for eight months and found that they remained intact in their new form during this period. But longer monitoring would be needed to ensure that the transformation was permanent and that any process of cell transformation with genes carries the risk of mutations, including the formation of cancers.

"We have not found any of these signs so far but it's really short-term," Kurita said. "For the future, we must work with the utmost caution to eliminate this kind of side effects."