Human Umbilical Cord Mesenchymal Stem Cell-Derived Exosomes Accelerate Diabetic Wound Healing via Ameliorating Oxidative Stress and Promoting Angiogenesis

Yan, Chenchen; Xv, Yan; Lin, Ze; Endo, Yori; Xue, Hang; Hu, Yiqiang; Hu, Liangcong; Chen, Lang; Cao, Faqi; Zhou, Wu; Zhang, Peng; Liu, Guohui

doi:10.3389/fbioe.2022.829868

Cited by 51 publications

(56 citation statements)

References 45 publications

(48 reference statements)

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“…Accelerated wound healing was associated with keratinocyte migration, restoration of FGF-7 levels, and decreased inflammation. The promotion of angiogenesis with accelerated diabetic wound healing in diabetic mice was also reported with exosomes derived from human umbilical cord mesenchymal stem cells via oxidative stress amelioration [ 43 ]. Decreased angiogenesis or neovascularization in hyperglycemic state and old age may be due to senescent endothelial cells (ECs) or decreased ECs proliferation.…”

Section: Stem-cell Derived Exosomes and Combinational Strategies To E...mentioning

confidence: 94%

Stem Cells and Angiogenesis: Implications and Limitations in Enhancing Chronic Diabetic Foot Ulcer Healing

Rai

Moellmer

Agrawal

2022

Cells

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Nonhealing diabetic foot ulcers (DFUs) are a continuing clinical issue despite the improved treatment with wound debridement, off-loading the ulcer, medication, wound dressings, and preventing infection by keeping the ulcer clean. Wound healing is associated with granulation tissue formation and angiogenesis favoring the wound to enter the resolution phase of healing followed by healing. However, chronic inflammation and reduced angiogenesis in a hyperglycemic environment impair the normal healing cascade and result in chronically non-healing diabetic foot ulcers. Promoting angiogenesis is associated with enhanced wound healing and using vascular endothelial growth factors has been proven beneficial to promote neo-angiogenesis. However, still, nonhealing DFUs persist with increased risks of amputation. Regenerative medicine is an evolving branch applicable in wound healing with the use of stem cells to promote angiogenesis. Various studies have reported promising results, but the associated limitations need in-depth research. This article focuses on summarizing and critically reviewing the published literature since 2021 on the use of stem cells to promote angiogenesis and enhance wound healing in chronic non-healing DFUs.

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Section: Stem-cell Derived Exosomes and Combinational Strategies To E...mentioning

confidence: 94%

Stem Cells and Angiogenesis: Implications and Limitations in Enhancing Chronic Diabetic Foot Ulcer Healing

Rai

Moellmer

Agrawal

2022

Cells

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“…Due to their pluripotency, HUCMSCs are considered high profile. Recently, HUCMSCs have been used for injury repair in different clinical fields [ 113 ]. Some studies have shown that HUCMSCs can enhance the formation of new blood vessels and strengthen tissue regeneration [ 113 ].…”

Section: Stem Cell Therapymentioning

confidence: 99%

“…Recently, HUCMSCs have been used for injury repair in different clinical fields [ 113 ]. Some studies have shown that HUCMSCs can enhance the formation of new blood vessels and strengthen tissue regeneration [ 113 ]. In two different studies, Qin et al used HUCSCs in the treatment of DFU after angioplasty.…”

Section: Stem Cell Therapymentioning

confidence: 99%

“…Studies have also shown that exosomes derived from HUCMSCs can modulate proliferation and differentiation of BMMSCs [ 115 ] in addition to their ability to regulate oxidative stress and hinder cell hypoxia damage [ 116 ]. According to these results, exosomes are considered promising for the promotion of angiogenesis in wound healing [ 113 ]. Yan et al investigated the effects of HUCMSCs and HUC-Exos (exosomes secreted by HUCMSCs) on diabetic wound healing.…”

Section: Stem Cell Therapymentioning

confidence: 99%

“…This study proposed that addressing diabetic cutaneous wounds can be achieved through a mixed injection, which could reduce the medical and economic burden. In addition, this therapeutic approach could be promising for treating diabetic wounds in the future [ 113 ].…”

Section: Stem Cell Therapymentioning

confidence: 99%

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Stem Cell-Based Therapy: A Promising Treatment for Diabetic Foot Ulcer

et al. 2022

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Diabetic foot ulcer (DFU) is a severe complication of diabetes and a challenging medical condition. Conventional treatments for DFU have not been effective enough to reduce the amputation rates, which urges the need for additional treatment. Stem cell-based therapy for DFU has been investigated over the past years. Its therapeutic effect is through promoting angiogenesis, secreting paracrine factors, stimulating vascular differentiation, suppressing inflammation, improving collagen deposition, and immunomodulation. It is controversial which type and origin of stem cells, and which administration route would be the most optimal for therapy. We reviewed the different types and origins of stem cells and routes of administration used for the treatment of DFU in clinical and preclinical studies. Diabetes leads to the impairment of the stem cells in the diseased patients, which makes it less ideal to use autologous stem cells, and requires looking for a matching donor. Moreover, angioplasty could be complementary to stem cell therapy, and scaffolds have a positive impact on the healing process of DFU by stem cell-based therapy. In short, stem cell-based therapy is promising in the field of regenerative medicine, but more studies are still needed to determine the ideal type of stem cells required in therapy, their safety, proper dosing, and optimal administration route.

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

Hetta,

Elsaghir,

Sijercic

et al. 2024

Health Science Reports

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BackgroundDiabetes has evolved into a worldwide public health issue. One of the most serious complications of diabetes is diabetic foot ulcer (DFU), which frequently creates a significant financial strain on patients and lowers their quality of life. Up until now, there has been no curative therapy for DFU, only symptomatic relief or an interruption in the disease's progression. Recent studies have focused attention on mesenchymal stem cells (MSCs), which provide innovative and potential treatment candidates for several illnesses as they can differentiate into various cell types. They are mostly extracted from the placenta, adipose tissue, umbilical cord (UC), and bone marrow (BM). Regardless of their origin, they show comparable features and small deviations. Our goal is to investigate MSCs' therapeutic effects, application obstacles, and patient benefit strategies for DFU therapy.MethodologyA comprehensive search was conducted using specific keywords relating to DFU, MSCs, and connected topics in the databases of Medline, Scopus, Web of Science, and PubMed. The main focus of the selection criteria was on English‐language literature that explored the relationship between DFU, MSCs, and related factors.Results and DiscussionNumerous studies are being conducted and have demonstrated that MSCs can induce re‐epithelialization and angiogenesis, decrease inflammation, contribute to immunological modulation, and subsequently promote DFU healing, making them a promising approach to treating DFU. This review article provides a general snapshot of DFU (including clinical presentation, risk factors and etiopathogenesis, and conventional treatment) and discusses the clinical progress of MSCs in the management of DFU, taking into consideration the side effects and challenges during the application of MSCs and how to overcome these challenges to achieve maximum benefits.ConclusionThe incorporation of MSCs in the management of DFU highlights their potential as a feasible therapeutic strategy. Establishing a comprehensive understanding of the complex relationship between DFU pathophysiology, MSC therapies, and related obstacles is essential for optimizing therapy outcomes and maximizing patient benefits.

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Human Umbilical Cord Mesenchymal Stem Cell-Derived Exosomes Accelerate Diabetic Wound Healing via Ameliorating Oxidative Stress and Promoting Angiogenesis

Cited by 51 publications

References 45 publications

Stem Cells and Angiogenesis: Implications and Limitations in Enhancing Chronic Diabetic Foot Ulcer Healing

Stem Cells and Angiogenesis: Implications and Limitations in Enhancing Chronic Diabetic Foot Ulcer Healing

Stem Cell-Based Therapy: A Promising Treatment for Diabetic Foot Ulcer

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

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