Improved enzymatic isolation of fibroblasts for the creation of autologous skin substitutes.

The number of medical applications using autologous fibroblasts is increasing rapidly. We investigated thoroughly the procedure to isolate cells from skin using the enzymatic tissue dissociation procedure. Tissue digestion efficiency, cell viability, and yield were investigated in relation to size of tissue fragments, digestion volume to tissue ratio, digestion time, and importance of other protease activities present in Clostridium histolyticum collagenase (CHC) (neutral protease, clostripain, and trypsin). The results showed that digestion was optimal with small tissue fragments (2-3 mm3) and with volumes tissue ratios > or =2 ml/g tissue. For incubations < or =10 h, the digestion efficiency and cell isolation yields were significantly improved by increasing the collagenase, neutral protease, or clostripain activity, whereas trypsin activity had no effects. However, a too high proteolytic activity of one of the proteases present in CHC digestion solution or long exposure times interfered with cell viability and cell culture yields. The optimal range of CHC proteases activities per milliliter digestion solutions was determined for digestions < or =10 h (collagenase 2700-3900 Mandl U/ml, neutral protease 5100-10,000 caseinase U/ml, and clostripain 35-48 BAEE U/ml) and for longer digestions (>14 h) (collagenase 1350- 3000 U/ml, neutral protease 2550-7700 U/ml, and clostripain 18-36 U/ml). Using these conditions, a maximum fibroblast expansion was achieved when isolated cells were seeded at 1 x 10(4) cells/cm2. These results did not only allow selection of optimal CHC batches able to digest dermal tissue with an high cell viability but also significantly increased the fibroblast yields, enabling us to produce autologous dermal tissue in a clinically acceptable time frame of 3 wk.