Long Noncoding RNA GAS5 Contained in Exosomes Derived from Human Adipose Stem Cells Promotes Repair and Modulates Inflammation in a Chronic Dermal Wound Healing Model.

Chronic recalcitrant wounds result from delayed or slowed healing processes. Underlying inflammation is a substantial risk factor for impaired dermal wound healing and often leads to chronic wound-related sequelae. Human adipose stem cells (hASCs) have shown tremendous potential in regenerative medicine. The goal of this project was to improve the outcome of chronic wounds by harvesting the exosomes from hASCs for therapeutic intervention. The results demonstrate that long noncoding RNA GAS5 is highly enriched in hASC exosomes and, further, that GAS5 is central to promoting wound repair in vitro. To evaluate the outcome of wound healing in a chronic low-grade inflammatory environment, lipopolysaccharide-treated HDF cells were evaluated for their response to hASC exosome treatment. Ingenuity pathway analysis identified inflammation pathways and genes affected by exosomes in a GAS5-dependent manner. Using siRNA to deplete GAS5 in HDF, the results demonstrated that Toll-like receptor 7 (TLR7) expression levels were regulated by GAS5. Importantly, the results demonstrate that GAS5 regulates inflammatory pathway genes in a chronic inflammation environment. The results presented here demonstrate that hASC exosomes are a viable therapeutic that accelerate the healing of chronic recalcitrant wounds.

Treatment of eccrine carcinoma of the chin via submental island flap.

BACKGROUND: The submental artery island flap is a reliable reconstructive option for lower face defects. Advantages of this flap include suppleness of tissue, excellent color and texture match to facial skin, a wide arc of rotation, prominent blood supply, and a well-hidden donor site scar. METHODS: This article describes a 61-year-old man with eccrine carcinoma of the chin necessitating extensive excision. A submental artery island flap was used for the reconstruction of the extended chin subunit. RESULTS: The operation resulted in excellent aesthetic outcome and maintenance of oral competence. CONCLUSION: The submental artery island flap utilizes loose tissue of the submental area to effectively and reliably reconstruct the soft tissue subunits of the chin and is a superb option for sizable defects. The flap is sufficiently well vascularized to tolerate postoperative radiation therapy without significant fibrosis or retraction.