Stem Cell-Based Therapy for Diabetic Foot Ulcers.

Qian Yu,Guo-Hong Qiao,Yaoxiang Sun,Li Yu,Tie-Liang Ma,Min Wang,Hui Shi

doi:10.3389/fcell.2022.812262

Abstract

Diabetic foot ulcer has become a worldwide clinical medical challenge as traditional treatments are not effective enough to reduce the amputation rate. Therefore, it is of great social significance to deeply study the pathogenesis and biological characteristics of the diabetic foot, explore new treatment strategies and promote their application. Stem cell-based therapy holds tremendous promise in the field of regenerative medicine, and its mechanisms include promoting angiogenesis, ameliorating neuroischemia and inflammation, and promoting collagen deposition. Studying the specific molecular mechanisms of stem cell therapy for diabetic foot has an important role and practical clinical significance in maximizing the repair properties of stem cells. In addition, effective application modalities are also crucial in order to improve the survival and viability of stem cells at the wound site. In this paper, we reviewed the specific molecular mechanisms of stem cell therapy for diabetic foot and the extended applications of stem cells in recent years, with the aim of contributing to the development of stem cell-based therapy in the repair of diabetic foot ulcers.

Highlights

Diabetic foot is the most common complication of diabetes and is prone to recurrence and infection
The results showed that hUBC-mesenchymal stem cells (MSCs) themselves did not secrete more extracellular matrix (ECM) components than fibroblasts, but hUBC-MSCs stimulated the synthesis of ECM in diabetic fibroblasts much more than in fibroblasts
Stem cell-based therapies are promising in the field of regenerative medicine, and their mechanisms include promoting angiogenesis, ameliorating neuroischemia and inflammation, and promoting collagen deposition

Summary

INTRODUCTION

Diabetic foot is the most common complication of diabetes and is prone to recurrence and infection. Angioplasty combined with human umbilical cord mesenchymal stem cells (hUC-MSCs) transplantation can improve the blood supply of severe diabetic foot, promote ulcer healing, reduce amputation rate and mortality, and improve the quality of life of patients with advanced diabetic foot (Qin et al, 2016). There is evidence that the application of myogenic mesenchymal stem cells (MMSCs) can essentially reverse the vascular occlusion of diabetes-related peripheral artery disease (PAD) (Hedhli et al, 2017) In contrast to this eminent function of stem cells, the mechanisms underlying an impaired wound healing process are poorly understood. Different types of stem cells can improve chronic diabetic wounds by enhancing the expression levels of vascular endothelial growth factor (VEGF), promoting cell proliferation, angiogenesis, and granulation tissue formation in traumatic tissues (Lee et al, 2011; Wan et al, 2013). TNF-α, as an essential component at the wound site, could secret VEGF and HGF by TABLE 1 | Potential role of stem cells in the healing process of DFUs

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