Treatment of Diabetic Foot with Autologous Stem Cells: A Meta-Analysis of Randomized Studies

Dai, Jie; Jiang, Cen; Chen, Hua; Chai, Yimin

doi:10.1155/2020/6748530

Cited by 16 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In humans, the injection of autologous micro-fragmented adipose tissue [ 239 ] and combination therapies with umbilical cord MSCs improved healing outcomes [ 240 ]. A recent meta-analysis found lower amputation rates and increased wound healing in autologous stem cell treatment randomized controlled trials [ 241 ]. Cell-free therapies using adipose MSC conditioned media [ 182 ] and exosomes [ 207 , 208 , 209 ] to treat wounds are also in development.…”

Section: Treatment Strategiesmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

View full text Add to dashboard Cite

Diabetes mellitus is an increasingly prevalent chronic metabolic disease characterized by prolonged hyperglycemia that leads to long-term health consequences. It is estimated that impaired healing of diabetic wounds affects approximately 25% of all patients with diabetes mellitus, often resulting in lower limb amputation, with subsequent high economic and psychosocial costs. The hyperglycemic environment promotes the formation of biofilms and makes diabetic wounds difficult to treat. In this review, we present updates regarding recent advances in our understanding of the pathophysiology of diabetic wounds focusing on impaired angiogenesis, neuropathy, sub-optimal chronic inflammatory response, barrier disruption, and subsequent polymicrobial infection, followed by current and future treatment strategies designed to tackle the various pathologies associated with diabetic wounds. Given the alarming increase in the prevalence of diabetes, and subsequently diabetic wounds, it is imperative that future treatment strategies target multiple causes of impaired healing in diabetic wounds.

show abstract

Section: Treatment Strategiesmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

View full text Add to dashboard Cite

show abstract

“…27 Furthermore, a meta-analysis of autologous MSC Tx for DFUs revealed that this treatment contributed to preventing foot amputation and improved wound healing. 28 Thus, autologous MSC Tx is considered a promising therapy for DFUs because of its good therapeutic outcomes without using immunosuppressants. However, autologous MSC Tx includes some limitations in that the recovery of MSCs is an invasive procedure, 16 and the process is time-consuming and expensive.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, a meta‐analysis of autologous MSC Tx for DFUs revealed that this treatment contributed to preventing foot amputation and improved wound healing 28 . Thus, autologous MSC Tx is considered a promising therapy for DFUs because of its good therapeutic outcomes without using immunosuppressants.…”

Section: Discussionmentioning

confidence: 99%

Xenotransplantation of neonatal porcine bone marrow–derived mesenchymal stem cells improves diabetic wound healing by promoting angiogenesis and lymphangiogenesis

Yamada

Naito

Nishimura

et al. 2022

Xenotransplantation

View full text Add to dashboard Cite

Background: Some clinical trials have shown the usefulness of stem cell therapy for diabetic foot ulcers. However, the donor supply is limited, and the process is time consuming and expensive. This study assessed the therapeutic effects of neonatal porcine bone marrow-derived mesenchymal stem cell (npBM-MSC) xenotransplantation using diabetic wound model mice.Methods: All layers of back skin were removed from streptozotocin-induced diabetic mice. In the npBM-MSCs group, npBM-MSCs were transplanted to the wound, and syngeneic mouse bone marrow-derived mesenchymal stem cells (mBM-MSCs) were transplanted to the wound in the mBM-MSCs group. The control group comprised diabetic mice that did not receive cellular therapy. The therapeutic effects of the transplantation were evaluated according to the rate of wound closure and the promotion of neovascularization in the wound. Results:The wound closure rate was significantly improved in the npBM-MSCs group compared with the control group (p < .001 at postoperative day [POD] 4 and p < .01 at POD 7) and mBM-MSCs groups (p < .05 at POD 4). Prominent promotion of both angiogenesis and lymphangiogenesis was observed in the npBM-MSCs group. Furthermore, the expression of murine Prox1 and both porcine and murine Vegfs and Tgfb1 in

show abstract

“…Recent studies have proven that stem cell therapy could reduce the amputation rate; however, the relationship between chronic wounds that lead to amputation and stem cells has rarely been discussed in detail [ 15 , 16 ]. Although there have been some meta-analyses of stem cell therapy in treating chronic wounds, most of the studies have investigated one etiology at a time, such as DM or CLI alone [ 17 , 18 ]. One study indicated that updated randomized controlled trials (RCTs) were not included in those studies [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials

Chiang

Chiu

Kang

et al. 2021

Cells

View full text Add to dashboard Cite

Lower extremity chronic wounds (LECWs) commonly occur in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD). Autologous stem cell therapy (ASCT) has emerged as a promising alternative treatment for those who suffered from LECWs. The purpose of this study was to assess the effects of ASCT on LECWs. Two authors searched three core databases, and independently identified evidence according to predefined criteria. They also individually assessed the quality of the included randomized controlled trials (RCTs), and extracted data on complete healing rate, amputation rate, and outcomes regarding peripheral circulation. The extracted data were pooled using a random-effects model due to clinical heterogeneity among the included RCTs. A subgroup analysis was further performed according to etiology, source of stem cells, follow-up time, and cell markers. A total of 28 RCTs (n = 1096) were eligible for this study. The pooled results showed that patients receiving ASCT had significantly higher complete healing rates (risk ratio (RR) = 1.67, 95% confidence interval (CI) 1.28–2.19) as compared with those without ASCT. In the CD34+ subgroup, ASCT significantly led to a higher complete healing rate (RR = 2.70, 95% CI 1.50–4.86), but there was no significant difference in the CD34− subgroup. ASCT through intramuscular injection can significantly improve wound healing in patients with LECWs caused by either DM or critical limb ischemia. Lastly, CD34+ is an important cell marker for potential wound healing. However, more extensive scale and well-designed studies are necessary to explore the details of ASCT and chronic wound healing.

show abstract

Treatment of Diabetic Foot with Autologous Stem Cells: A Meta-Analysis of Randomized Studies

Cited by 16 publications

References 30 publications

Diabetic Wound-Healing Science

Diabetic Wound-Healing Science

Xenotransplantation of neonatal porcine bone marrow–derived mesenchymal stem cells improves diabetic wound healing by promoting angiogenesis and lymphangiogenesis

Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials

Contact Info

Product

Resources

About