By Elodie Vaz | Published on February 24, 2026 | 3 min read
The tragedy
that struck Crans-Montana on the night of January 1, 2026, at the Le
Constellation bar claimed the lives of more than forty people and left dozens
of young individuals with severe burns. The event starkly highlights how the
management of severely burned patients remains a major challenge for modern
medicine. Among roughly fifty victims with extensive burns, specialized Swiss
and European centers are working to stabilize vital functions, prevent
complications, and initiate skin reconstruction—a process that can last months
or even years.
In this
demanding clinical context, recent advances in tissue repair—particularly
involving mesenchymal stem/stromal cells (MSCs) and their derivatives—offer new
perspectives. First described in the late 1960s by Alexander Friedenstein, MSCs
were initially identified in bone marrow as a fibroblast-like population. In
the 1990s, it was demonstrated that MSCs possess multipotent differentiation
capacity as well as the ability to secrete numerous trophic factors involved in
angiogenesis, modulation of inflammation, and cell survival.
MSCs: a
foundational discovery for tissue repair
These
mechanisms have proven essential in tissue repair and regeneration processes.
“In the early 2000s, we developed a protocol for isolating and culturing these
cells from bone marrow, tailored to their application in repairing accidental
localized radiation-induced burns. This marked a foundational step in
recognizing these cells as Advanced Therapy Medicinal Products (ATMPs),”
recalled Jean-Jacques Lataillade, Director of the Armed Forces Blood
Transfusion Center (HNIA PERCY), during a press conference at the Academy of
Surgery on February 11.
The
secretome at the core of new treatments
However,
clinical implementation involves logistical, biological, and regulatory
constraints. Therapeutic mechanisms rely less on direct cellular
differentiation than on interactions between MSCs and their environment via
their secretome, which includes cytokines, growth factors, and, notably,
extracellular vesicles (EVs).
These
EVs—lipid-bound structures containing active biomolecules—largely reproduce the
biological effects of their parent cells both in vitro and in vivo. Their
stability, ease of storage, and potential for administration outside cell
production platforms have led to the emergence of an acellular therapy
paradigm. French research is highly active in this field. Although these
products do not fall under ATMP status, they are classified as biological
medicinal products and are generating both academic and industrial development.
Vesicles
become dressings
A concrete
illustration of this evolution is the collaborative BRAVE project between
INSERM, the French Armed Forces Health Service, and Brothier. The project aims
to integrate MSC-derived EVs into a calcium alginate dressing—a support already
routinely used for severely burned patients—in order to accelerate graft take
and wound healing. This type of approach, combining cell biology and
biomaterials engineering, could help reduce the time required for skin
reconstruction in contexts such as Crans-Montana, where grafting procedures and
dressing changes under anesthesia remain demanding and repetitive steps.
Surgery
and biotherapies: a combined strategy
In cases of
deep burns, reconstructive surgery remains essential, involving excision of
necrotic tissue and skin grafting—often autologous—to restore the integrity of
the skin barrier. However, integrating paracrine or acellular therapies may
ultimately optimize graft take, modulate local inflammation, and reduce
functional sequelae.
Thus,
tissue reconstruction for severely burned patients is evolving toward
integrated strategies that combine advanced surgical interventions, biological
modulation, and pharmacological innovation. Although technical and regulatory
challenges remain, these developments offer promising avenues to improve both
the speed and quality of healing following severe trauma.
Read next: L’administration
de glutamine par voie entérale ne réduirait pas le temps d’hospitalisation des
grands brûlés.
About
the Author –
Elodie Vaz
Health journalist, CFPJ graduate (2023).
Élodie explores the marks diseases leave on bodies and, more broadly, on
human life. A registered nurse since 2010, she spent twelve years at patients’
bedsides before exchanging her stethoscope for a notebook. She now investigates
the links between environment and health, convinced that the vitality of life
cannot be reduced to that of humans alone.
