Intravenous placenta-derived mesenchymal stem cells enhance early survival as an adjunct to supportive care in severe burn: a preclinical study

BACKGROUND: Severe burn injury induces a rapid systemic inflammatory response, and early survival depends heavily on timely fluid resuscitation and thermal support. However, optimal supportive care may be difficult to deliver in austere or resource-limited environments. Placenta-derived choriodecidual mesenchymal stem cells (pcMSCs) possess immunomodulatory properties and may improve outcomes when supportive care is suboptimal. This study investigated whether intravenous pcMSC therapy improves early survival after severe burn injury in a preclinical model. METHODS: Sixty adult male Sprague-Dawley rats underwent standardized 40% total body surface area full-thickness burns and were randomly assigned to six groups (n = 10/group) differing in fluid resuscitation (1× vs. 3× Ringer's lactate), thermal support (heating lamp vs. incubator warming), and intravenous pcMSC therapy. Survival was monitored for 14 days and analyzed using Kaplan-Meier methods with log-rank testing. Serum TNF-α, IL-1β, and IL-6 levels, body weight, water intake, and core body temperature were assessed longitudinally in selected groups. RESULTS: Survival differed significantly among groups, with 93% of deaths occurring within the first 3 days post-burn. Under low-volume resuscitation, survival declined to 30% in untreated animals and improved to 50% with pcMSC therapy, indicating a survival benefit under insufficient resuscitation conditions. With adequate fluid resuscitation and thermal support, survival was high without pcMSCs (80%) and numerically higher with pcMSCs (90%), although this difference was not statistically significant after adjustment. Thermal support exerted a marked effect on outcomes, with warmed animals demonstrating substantially higher survival despite similar or lower fluid volumes. PcMSC treatment attenuated post-burn hypothermia, reduced weight loss and dehydration, and significantly decreased circulating TNF-α, IL-1β, and IL-6 levels. CONCLUSIONS: Placenta-derived choriodecidual mesenchymal stem cells may confer an additive survival benefit after severe burn injury, particularly under inadequate fluid resuscitation and thermal support, likely through stabilization of body temperature, improved hydration, and attenuation of systemic inflammation, supporting their potential role as an adjunctive therapy in austere or resource-limited settings.