Relevancia Estratégica de la Medicina Regenerativa aplicada al Ámbito Militar
DOI:
https://doi.org/10.47606/ACVEN/MV0362Palabras clave:
células madre, lesiones militares, medicina regenerativa, terapia celular, vesículas extracelularesResumen
Introducción: El personal militar enfrenta un elevado riesgo de lesiones musculoesqueléticas y nerviosas que pueden comprometer su funcionalidad y disponibilidad operativa. Objetivo: Examinar la relevancia estratégica y las posibles aplicaciones de la medicina regenerativa en lesiones de interés militar. Materiales y métodos: Se realizó una revisión narrativa no sistemática de literatura científica sobre terapias celulares y productos biológicos regenerativos, sus aplicaciones clínicas, riesgos y consideraciones regulatorias y éticas. No se empleó un protocolo de búsqueda con criterios de inclusión y exclusión predefinidos. Resultados: Los estudios preclínicos y los ensayos clínicos iniciales aportan resultados preliminares sobre células madre mesenquimales, concentrado de aspirado de médula ósea y otras estrategias en lesiones tendinosas, osteoarticulares y medulares. En afecciones visuales y auditivas, la evidencia sigue siendo principalmente preclínica. La heterogeneidad metodológica, las muestras pequeñas, los riesgos biológicos y las exigencias regulatorias restringen su aplicación habitual. Conclusión: La medicina regenerativa constituye una línea de investigación prometedora para la salud militar, pero requiere ensayos controlados, seguimiento prolongado y salvaguardas éticas antes de su implementación generalizada.
Descargas
Citas
Jiménez LEC, Buitrago PJM. Presencia de lesiones en el entrenamiento físico mílitar. Una experiencia de investigación en la escuela militar de cadetes General José María Cordova. Cuerpo, Cultura y Movimiento. 2018;8(2):35–47. https://doi.org/10.15332/2422474X/5125
Valero Capilla FA, Franco Bonafonte L, Rubio Pérez FJ. Lesiones de los sargentos alumnos del Ejército de Tierra y factores de riesgo lesional. Sanidad Militar. 2014;70(4):263–269. https://doi.org/10.4321/S1887-85712014000400004
David C, Pinillos R, Castro Jiménez LE, Janyn P, Buitrago M. Lesiones derivadas del entrenamiento militar en los cadetes de 6° nivel de la escuela militar José maría Córdova. Movimiento Científico. 2016;10(1):19–28. https://doi.org/10.33881/2011-7191.MCT.10102
Godoy-López J, Godoy-López J. 2009-2019: evolución de la epidemiología de lesiones deportivas en las Fuerzas Armadas. Sanidad Militar. 2022;78(4):229–235. https://doi.org/10.4321/S1887-85712022000400005
Christopherson GT, Nesti LJ. Stem cell applications in military medicine. Stem Cell Research & Therapy. 2011;2(5):40. https://doi.org/10.1186/SCRT81
Cárcamo Jaraba E. Trauma ocular durante exposición con armas de fragmentación en personal militar que son atendidos en el servicio de oftalmología del hospital militar central 2008-2009 [Trabajo de grado, Universidad Militar Nueva Granada]. 2013. https://hdl.handle.net/10654/10311
Hussain SF, Raza Z, Cash ATG, Zampieri T, Mazzoli RA, Kardon RH, et al. Traumatic brain injury and sight loss in military and veteran populations– a review. Military Medical Research, 8(1). 2021. https://doi.org/10.1186/S40779-021-00334-3
Hernández Sánchez H. Medio militar y trastornos auditivos inducidos por ruido. Revista Cubana de Medicina Militar. 2013;42(3):396–402. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572013000300006&lng=es&nrm=iso&tlng=es
Dunn JC, Eckhoff MD, Nicholson TC, Campbell W, Kenney K, Smith J, et al. Combat-Sustained Peripheral Nerve Injuries in the United States Military. Journal of Hand Surgery, 46(2), 148.e1-148.e8. 2021. https://doi.org/10.1016/j.jhsa.2020.08.004
Gaivoronsky AI, Kim-Skaliitchouk BV, Svistov DV, Isaev DM, Churikov LI. On the issue of modern classification of peripheral nervous system’s combat injuries. Kazan Medical Journal. 2024;105(5):760–770. https://doi.org/10.17816/KMJ375372
Howard IM, Sedarsky K, Gallagher M, Miller M, Puffer RC. Combat-related peripheral nerve injuries. Muscle and Nerve. 2025;71(5):768–781. https://doi.org/10.1002/MUS.28168
Massaza G. Trauma del nervio periférico en pacientes que asistieron a medicina electodiagnóstica en el servicio de medicina física y rehabilitación del Hospital Militar Central entre enero de 2004 y diciembre de 2005. Revista Colombiana de Rehabilitación. 2006;5(1):79–90. https://doi.org/10.30788/REVCOLREH.V5.N1.2018.283
García-Cañas R, Navarro-Suay R, Rodríguez-Moro C, Crego-Vita D, Bernácer-López J, Areta-Jiménez F. El patrón de lesión y su relación con el índice de gravedad en la baja de combate. Sanidad Militar. 2021;77(1):17–25. https://doi.org/10.4321/S1887-85712021000100003
Fleming ME, Bharmal H, Valerio I. Regenerative medicine applications in combat casualty care. Regenerative Medicine. 2014;9(2):179–190. https://doi.org/10.2217/rme.13.96
Saha B, Krishna Kumar H, Borgohain MP, Thummer RP. Prospective applications of induced pluripotent stem cells in military medicine. Medical Journal, Armed Forces India. 2018;74(4):313–320. https://doi.org/10.1016/j.mjafi.2018.03.005
Spear AM, Lawton G, Staruch RMT, Rickard RF. Regenerative medicine and war: a front-line focus for UK defence. Npj Regenerative Medicine. 2018;3(1):1–9. https://doi.org/10.1038/s41536-018-0053-4
Ude CC, Miskon A, Idrus RBH, Abu Bakar MBin. Application of stem cells in tissue engineering for defense medicine. Military Medical Research, 5(1). 2018. https://doi.org/10.1186/s40779-018-0154-9
Sampogna G, Guraya SY, Forgione A. Regenerative medicine: Historical roots and potential strategies in modern medicine. Journal of Microscopy and Ultrastructure. 2015;3(3):101–107. https://doi.org/10.1016/J.JMAU.2015.05.002
Hussen BM, Taheri M, Yashooa RK, Abdullah GH, Abdullah SR, Kheder RK, et al. Revolutionizing medicine: recent developments and future prospects in stem-cell therapy. International Journal of Surgery (London, England). 2024;110(12):8002. https://doi.org/10.1097/JS9.0000000000002109
Melnik S, Werth N, Boeuf S, Hahn EM, Gotterbarm T, Anton M, et al. Impact of c-MYC expression on proliferation, differentiation, and risk of neoplastic transformation of human mesenchymal stromal cells. Stem Cell Research and Therapy, 10(1). 2019. https://doi.org/10.1186/S13287-019-1187-Z
Prochazkova M, Chavez MG, Prochazka J, Felfy H, Mushegyan V, Klein OD. Embryonic Versus Adult Stem Cells. Stem Cell Biology and Tissue Engineering in Dental Sciences, 249–262. 2015. https://doi.org/10.1016/B978-0-12-397157-9.00020-5
Mejía-Barradas CM, Cázares-Montañez JE, Guerra-Márquez Á, Hernández-Chávez VG, Cáceres-Cortés JR, Gutiérrez-Iglesias G. Tratamiento regenerativo con células madre mesenquimales provenientes de la gelatina de Wharton de cordón umbilical en la úlcera crónica por dermolipectomía. Cirugía y Cirujanos. 2019;87:8–16. https://doi.org/10.24875/CIRU.18000515
Knoepfler PS. Deconstructing stem cell tumorigenicity: A roadmap to safe regenerative medicine. Stem Cells. 2009;27(5):1050–1056. https://doi.org/10.1002/STEM.37
Arcani R, Velier M, Sabatier F, Simoncini S, Abellan-Lopez M, Granel B, et al. Nanofat Use in Regenerative Medicine: A Systematic Literature Review and Consensus Recommendations from Expert Opinions. Facial Plastic Surgery and Aesthetic Medicine. 2025. https://doi.org/10.1089/FPSAM.2024.0385
Grünherz L, Sanchez-Macedo N, Frueh FS, McLuckie M, Lindenblatt N. Nanofat applications: from clinical esthetics to regenerative research: Potential applications of nanofat in tissue regeneration with a focus on wound healing and vascularization. Current Opinion in Biomedical Engineering. 2019;10:174–180. https://doi.org/10.1016/J.COBME.2019.07.002
Kushida Y, Wakao S, Dezawa M. Muse cells are endogenous reparative stem cells. Advances in Experimental Medicine and Biology. 2018;1103:43–68. https://doi.org/10.1007/978-4-431-56847-6_3
Velasco MG, Satué K, Chicharro D, Martins E, Torres-Torrillas M, Peláez P, et al. Multilineage-Differentiating Stress-Enduring Cells (Muse Cells): The Future of Human and Veterinary Regenerative Medicine. Biomedicines, 11(2). 2023. https://doi.org/10.3390/BIOMEDICINES11020636
Das A, Sinha M, Datta S, Abas M, Chaffee S, Sen CK, et al. Monocyte and Macrophage Plasticity in Tissue Repair and Regeneration. American Journal of Pathology. 2015;185(10):2596–2606. https://doi.org/10.1016/j.ajpath.2015.06.001
Na YR, Kim SW, Seok SH. A new era of macrophage-based cell therapy. Experimental and Molecular Medicine. 2023;55(9):1945–1954. https://doi.org/10.1038/s12276-023-01068-z
Spiller KL, Koh TJ. Macrophage-based therapeutic strategies in regenerative medicine. Advanced Drug Delivery Reviews. 2017;122:74–83. https://doi.org/10.1016/j.addr.2017.05.010
Da Silva K, Kumar P, Choonara YE. The paradigm of stem cell secretome in tissue repair and regeneration: Present and future perspectives. Wound Repair and Regeneration, 33(1). 2025. https://doi.org/10.1111/WRR.13251
Joshi JM, Muttigi MS, Upadhya R, Seetharam RN. An overview of the current advances in the treatment of inflammatory diseases using mesenchymal stromal cell secretome. Immunopharmacology and Immunotoxicology. 2023;45(4):497–507. https://doi.org/10.1080/08923973.2023.2180388
Farahzadi R, Valipour B, Montazersaheb S, Fathi E. Targeting the stem cell niche micro-environment as therapeutic strategies in aging. Frontiers in Cell and Developmental Biology, 11. 2023. https://doi.org/10.3389/FCELL.2023.1162136
Velikic G, Maric DM, Maric DL, Supic G, Puletic M, Dulic O, et al. Harnessing the Stem Cell Niche in Regenerative Medicine: Innovative Avenue to Combat Neurodegenerative Diseases. International Journal of Molecular Sciences, 25(2). 2024. https://doi.org/10.3390/IJMS25020993
Wagers AJ. The stem cell niche in regenerative medicine. Cell Stem Cell. 2012;10(4):362–369. https://doi.org/10.1016/j.stem.2012.02.018
Welsh JA, Goberdhan DCI, O'Driscoll L, Buzas EI, Blenkiron C, Bussolati B, et al. Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches. Journal of Extracellular Vesicles. 2024;13(2):e12404. https://doi.org/10.1002/jev2.12404
Odehnalová N, Šandriková V, Hromadka R, Skali?ková M, Dytrych P, Hoskovec D, et al. The potential of exosomes in regenerative medicine and in the diagnosis and therapies of neurodegenerative diseases and cancer. Frontiers in Medicine. 2025;12:1539714. https://doi.org/10.3389/FMED.2025.1539714/XML
Collins T, Alexander D, Barkatali B. Platelet-rich plasma: a narrative review. EFORT Open Reviews. 2021;6(4):225–235. https://doi.org/10.1302/2058-5241.6.200017
Karimi K, Rockwell H. The Benefits of Platelet-Rich Fibrin. Facial Plastic Surgery Clinics of North America. 2019;27(3):331–340. https://doi.org/10.1016/j.fsc.2019.03.005
Murray T, Khetarpal S. Platelet-Rich Fibrin. Advances in Cosmetic Surgery. 2022;5(1):9–16. https://doi.org/10.1016/j.yacs.2021.12.001
Yuan Y, Cao K, Gao P, Wang Y, An W, Dong Y. Extracellular vesicles and bioactive peptides for regenerative medicine in cosmetology. Ageing Research Reviews. 2025;107:102712. https://doi.org/10.1016/J.ARR.2025.102712
Law L, Hunt CL, Van Wijnen AJ, Nassr A, Larson AN, Eldrige JS, et al. Office-Based Mesenchymal Stem Cell Therapy for the Treatment of Musculoskeletal Disease: A Systematic Review of Recent Human Studies. Pain Medicine (United States). 2019;20(8):1570–1583. https://doi.org/10.1093/PM/PNY256
Cotter EJ, Wang KC, Yanke AB, Chubinskaya S. Bone Marrow Aspirate Concentrate for Cartilage Defects of the Knee: From Bench to Bedside Evidence. Cartilage. 2018;9(2):161–170. https://doi.org/10.1177/1947603517741169
Park D, Koh HS, Choi YH, Park I. Bone Marrow Aspirate Concentrate (BMAC) for Knee Osteoarthritis: A Narrative Review of Clinical Efficacy and Future Directions. Medicina (Lithuania), 61(5). 2025. https://doi.org/10.3390/MEDICINA61050853
Mao XF, Zhang XQ, Yao ZY, Mao HJ. Advances in mesenchymal stem cells therapy for tendinopathies. Chinese Journal of Traumatology - English Edition. 2024;27(1):11–17. https://doi.org/10.1016/j.cjtee.2023.11.002
Quintero D, Perucca Orfei C, Kaplan LD, de Girolamo L, Best TM, Kouroupis D. The roles and therapeutic potentialof mesenchymal stem/stromal cells and their extracellular vesicles in tendinopathies. Frontiers in Bioengineering and Biotechnology, 11. 2023. https://doi.org/10.3389/FBIOE.2023.1040762
Cho WS, Chung SG, Kim W, Jo CH, Lee SU, Lee SY. Mesenchymal Stem Cells Use in the Treatment of Tendon Disorders: A Systematic Review and Meta-Analysis of Prospective Clinical Studies. Annals of Rehabilitation Medicine. 2021;45(4):274–283. https://doi.org/10.5535/ARM.21078
Soler R, Rodas G, Rius-Tarruella J, Alomar X, Balius R, Ruíz-Cotorro Á, et al. Safety and Efficacy of Bone Marrow–Derived Mesenchymal Stem Cells for Chronic Patellar Tendinopathy (With Gap >3 mm) in Patients: 12-Month Follow-up Results of a Phase 1/2 Clinical Trial. Orthopaedic Journal of Sports Medicine, 11(9). 2023. https://doi.org/10.1177/23259671231184400
Lee J, Nguyen S, Bhattacharya S. Optic nerve regeneration: Potential treatment approaches. Current Opinion in Pharmacology. 2024;74:102428. https://doi.org/10.1016/J.COPH.2023.102428
Vrathasha V, Nikonov S, Bell BA, He J, Bungatavula Y, Uyhazi KE, et al. Transplanted human induced pluripotent stem cells- derived retinal ganglion cells embed within mouse retinas and are electrophysiologically functional. IScience. 2022;25(11):105308. https://doi.org/10.1016/J.ISCI.2022.105308
Zhang Q, Tang J, Liu L, Liu Z, Xue J, Ge J, et al. Emerging therapeutic strategies for optic nerve regeneration. Trends in Pharmacological Sciences. 2025;46(1):45–61. https://doi.org/10.1016/J.TIPS.2024.11.008
Kuriyan AE, Albini TA, Townsend JH, Rodriguez M, Pandya HK, Leonard RE, et al. Vision loss after intravitreal injection of autologous "stem cells" for AMD. New England Journal of Medicine. 2017;376(11):1047–1053.
Kanzaki S, Toyoda M, Umezawa A, Ogawa K. Application of mesenchymal stem cell therapy and inner ear regeneration for hearing loss: A review. International Journal of Molecular Sciences. 2020;21(16):1–15. https://doi.org/10.3390/IJMS21165764
Awidi A, Al Shudifat A, El Adwan N, Alqudah M, Jamali F, Nazer F, et al. Safety and potential efficacy of expanded mesenchymal stromal cells of bone marrow and umbilical cord origins in patients with chronic spinal cord injuries: a phase I/II study. Cytotherapy. 2024;26(8):825–831. https://doi.org/10.1016/j.jcyt.2024.03.480
Macêdo CT, de Freitas Souza BS, Villarreal CF, Silva DN, da Silva KN, de Souza CLeM, et al. Transplantation of autologous mesenchymal stromal cells in complete cervical spinal cord injury: a pilot study. Frontiers in Medicine, 11. 2024. https://doi.org/10.3389/FMED.2024.1451297
Montoto-Meijide R, Meijide-Faílde R, Díaz-Prado SM, Montoto-Marqués A. Mesenchymal Stem Cell Therapy in Traumatic Spinal Cord Injury: A Systematic Review. International Journal of Molecular Sciences 2023, Vol. 24, Page 11719. 2023;24(14):11719. https://doi.org/10.3390/IJMS241411719
Zeng CW. Multipotent Mesenchymal Stem Cell-Based Therapies for Spinal Cord Injury: Current Progress and Future Prospects. Biology, 12(5). 2023. https://doi.org/10.3390/BIOLOGY12050653
Bydon M, Qu W, Moinuddin FM, Hunt CL, Garlanger KL, Reeves RK, et al. Intrathecal delivery of adipose-derived mesenchymal stem cells in traumatic spinal cord injury: Phase I trial. Nature Communications 2024 15:1. 2024;15(1):1–11. https://doi.org/10.1038/s41467-024-46259-y
Thompson M, Mei SHJ, Wolfe D, Champagne J, Fergusson D, Stewart DJ, et al. Cell therapy with intravascular administration of mesenchymal stromal cells continues to appear safe: An updated systematic review and meta-analysis. EClinicalMedicine. 2020;19:100249. https://doi.org/10.1016/j.eclinm.2019.100249
Amariglio N, Hirshberg A, Scheithauer BW, Cohen Y, Loewenthal R, Trakhtenbrot L, et al. Donor-derived brain tumor following neural stem cell transplantation in an ataxia telangiectasia patient. PLoS Medicine. 2009;6(2):e1000029. https://doi.org/10.1371/journal.pmed.1000029
Berkowitz AL, Miller MB, Mir SA, Cagney D, Chavakula V, Guleria I, et al. Glioproliferative lesion of the spinal cord as a complication of "stem-cell tourism". New England Journal of Medicine. 2016;375(2):196–198.
Turner L, Knoepfler P. Selling stem cells in the USA: Assessing the direct-to-consumer industry. Cell Stem Cell. 2016;19(2):154–157.
Asociación Médica Mundial. Declaración de Helsinki de la Asociación Médica Mundial: Principios éticos para las investigaciones médicas en seres humanos. 2013.
FDA. Public safety notification on exosome products. U.S. Food and Drug Administration. 2019.
ISSCR. Guidelines for stem cell research and clinical translation. International Society for Stem Cell Research. 2021.
Marks PW, Witten CM, Califf RM. Clarifying stem-cell therapy's benefits and risks. New England Journal of Medicine. 2017;376(11):1007–1009.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2026 Florencia Mansilla, José Luis Fliguer, Carlos Feleder
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
