Function and mechanism of mesenchymal stem cells in the healing of diabetic foot wounds

Abstract

Diabetes has become a global public health problem. Diabetic foot is one of the most severe complications of diabetes, which often places a heavy economic burden on patients and seriously affects their quality of life. The current conventional treatment for the diabetic foot can only relieve the symptoms or delay the progression of the disease but cannot repair damaged blood vessels and nerves. An increasing number of studies have shown that mesenchymal stem cells (MSCs) can promote angiogenesis and re-epithelialization, participate in immune regulation, reduce inflammation, and finally repair diabetic foot ulcer (DFU), rendering it an effective means of treating diabetic foot disease. Currently, stem cells used in the treatment of diabetic foot are divided into two categories: autologous and allogeneic. They are mainly derived from the bone marrow, umbilical cord, adipose tissue, and placenta. MSCs from different sources have similar characteristics and subtle differences. Mastering their features to better select and use MSCs is the premise of improving the therapeutic effect of DFU. This article reviews the types and characteristics of MSCs and their molecular mechanisms and functions in treating DFU to provide innovative ideas for using MSCs to treat diabetic foot and promote wound healing.

Efficacy of adipose‐derived mesenchymal stem cell therapy in the treatment of chronic micro‐ and macrovascular complications of diabetes

“…These positive effects were achieved by the secretion of several angiogenic growth factors (e.g. VEGF, FGF, stromal cell‐derived factor‐1, keratinocyte growth factor 2, IGF‐1, placental growth factor and epidermal growth factor) and stem cell differentiation into perivascular cells 132 . The current evidence suggests that both local and systemic ADMSC administration improve diabetic wounds in rodents.…”

Mesenchymal stem cell therapy in diabetic foot ulcer: An updated comprehensive review

“…It can also promote ulcer healing and is thought to be a vital approach in the management of DFU. 16,61,62 TCC is proven to be significantly superior to common dressing changes and other offloading ways of boosting ulcer healing and minimizing infection. 63,64 HBOT is a promising approach to overcome local hypoxia.…”

“…14,15 MSCs are an efficient method of treating DFU, as evidenced by the growing research that demonstrates their capacity to encourage reepithelialization and angiogenesis, decrease inflammation and the inflammatory process, take part in immunological control, and subsequently heal DFU. 16,17 This review article provides a general snapshot of DFU and discusses in detail MSCs and their role as a novel approach in the treatment of DFU. Moreover, it will take the challenges and general and specific limitations of MSCs into consideration and discuss how to overcome these obstacles.…”

Research Progress on Mesenchymal Stem Cells for the Treatment of Diabetes and Its Complications

“…It has been reported that 85% of patients with DM with DFUs have their limbs amputated, which severely affects their quality of life [ 58 ]. Treatment with AD-MSCs accelerates wound healing in mice with DFUs, improves the reepithelialization of injured skin, and increases vascular redistribution in traumatized tissue [ 59 ]. Mechanistically, AD-MSCs restore intraepidermal nerve fiber (IENF) density, reduce apoptosis in neurons and Schwann cells, promote angiogenesis, and reduce chronic inflammation in peripheral nerves [ 59 ].…”

“…Treatment with AD-MSCs accelerates wound healing in mice with DFUs, improves the reepithelialization of injured skin, and increases vascular redistribution in traumatized tissue [ 59 ]. Mechanistically, AD-MSCs restore intraepidermal nerve fiber (IENF) density, reduce apoptosis in neurons and Schwann cells, promote angiogenesis, and reduce chronic inflammation in peripheral nerves [ 59 ]. DFU model rats were treated intravenously with UC-MSCs and showed a significantly higher wound healing rate (45.1% ± 1.8% vs. 26.7% ± 2.1%) on day 8 and a wound healing rate approaching 90% on day 16 [ 60 ].…”