ABSTRACT
The treatment of severe burns relies on autologous skin grafts, which are limited due to donor-site
unavailability and substantial comorbidities. Current therapies are unable to eliminate substantial healing
defects in severe burns, underscoring the urgent needs of more effective therapies. Our long-term goals are
to develop better therapies for severe burns. Mesenchymal stem cells (MSCs) possess regenerative power for
burn wounds. Adipose-tissue derived microvascular fragments (MVFs) are native vascularization units and a
rich source of the MSCs, endothelial cells, perivascular cells, and adipocytes essential in rebuilding burn-
destroyed skin. MVFs provide a better niche for MSCs, maximizing MSC regenerative power. MVFs are also
easily isolated from fat tissue collected via minimally invasive liposuction. We have identified regenerative lipid
mediators (ReLiMs) that increase MSC or MVF proliferation, survival, and production of growth factors, and
promote tissue regeneration. ReLiM1 restored impaired vascularization and healing. However, ReLiMs have
short half-lives in wounds, limiting their utility for healing burns and functionalizing MSCs. To address this
problem, we developed a hydrogel that can sustain ReLiM levels in burn wounds. ReLiM release was
sustained from the hydrogel of biodegradable, non-toxic amino acid-based poly(ester amide) protein-mimic
polymers (AA-PEAs). The integration of a sustained-release ReLiM with an AA-PEA-hydrogel (Agel) matrix
accelerated healing and promoted MSC/MVF functions. We hypothesize that sustained release ReLiMs
combined with Agel scaffolds directly promote healing of severe burns and protect and guide MVF
regenerative functions. Our objective is to develop ReLiM-impregnated Agels that deliver ReLiMs and provide
scaffolds for healing severe burns and protecting and guiding MVF regenerative functions for better healing as
well as to decipher the mechanisms via which this occurs. Aim 1. We will develop the Agel to 1A) sustain
ReLiM release and to 1B) provide an optimal ReLiM-releasing biomimetic matrix for skin cell homing,
vascularization, and re-epithelization, as well as for the reduction of scarring and increasing wound breaking
strength. Aim 2. 2A) We will develop a construct that integrates uncultured autologous MVFs, sustained
release ReLiMs, and Agel scaffolds to maximize the healing of deep burns. We predict that the achieved
construct protects and guides MVF functions. We will verify results using human MVFs in vitro for better
translational value. 2B) We will decipher mechanisms for efficacy of the best MVF-ReLiM-Agel. Impact: This
project will provide 1) a ReLiM-Agel dressing that delivers ReLiMs and provides a matrix and covering for
efficient healing, 2) a ReLiM- and MVF-carrying Agel matrix that protects and guides uncultured MVFs for more
efficient healing, and 3) the underlying mechanistic knowledge. These regenerative lipid mediator
functionalized dressings with nonexistent or minimal graft-donor requirements are promising adjuvant therapy
to overcome the drawbacks of grafting methods or skin substitutes currently used to treat severe burns.