Preclinical and clinical evidence for stem cell therapies as treatment for diabetic wounds

Heublein, Hannes; Bader, Augustinus; Giri, Shibashish

doi:10.1016/j.drudis.2015.01.005

Cited by 37 publications

(25 citation statements)

References 135 publications

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“…The ASCs significantly improved wound healing outcomes by day 16 compared to the controls. Stem cell therapies delivered in biomaterials have also shown promise for burn wound healing (Ozturk and Karagoz, 2015), diabetic ulcers (Heublein et al, 2015), and cutaneous wound healing (Branski et al, 2009). Microporous annealed particle (MAP) gels were created by mixing pre-gel mixture including a PEG-VS containing an RGD peptide region and matrix metalloproteinase (MMP) substrate with MMP crosslinker solution in a microfluidic channel to make gels that were annealed using FXIIIa into a final microporous scaffold (Griffin et al, 2015).…”

Section: Biomaterial-based Wound Therapiesmentioning

confidence: 99%

“…However, many mechanistic aspects of wound repair remain poorly understood, we direct the reader to other reviews for further information about detailed mechanisms of wound healing (Martin, 1997; Gurtner et al, 2008; Eming et al, 2014). In addition, we refer the reader to reviews of gene and stem cell therapies for wound healing (Branski et al, 2009; Heublein et al, 2015), role of mechanical forces in wound healing (Agha et al, 2011; Wong et al, 2011a, 2012), and immune response to biomaterial implants (Franz et al, 2011) for further information on those topics. In this review, we will focus on biomaterial- and nanoparticle (NP)-based wound therapeutics, in particular, those that have significant preclinical development or are in clinical trials/clinical use.…”

Section: Introductionmentioning

confidence: 99%

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Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

Baker

2016

Front. Bioeng. Biotechnol.

233

196

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Wound healing is an intricate process that requires complex coordination between many cell types and an appropriate extracellular microenvironment. Chronic wounds often suffer from high protease activity, persistent infection, excess inflammation, and hypoxia. While there has been intense investigation to find new methods to improve cutaneous wound care, the management of chronic wounds, burns, and skin wound infection remain challenging clinical problems. Ideally, advanced wound dressings can provide enhanced healing and bridge the gaps in the healing processes that prevent chronic wounds from healing. These technologies have great potential for improving outcomes in patients with poorly healing wounds but face significant barriers in addressing the heterogeneity and clinical complexity of chronic or severe wounds. Active wound dressings aim to enhance the natural healing process and work to counter many aspects that plague poorly healing wounds, including excessive inflammation, ischemia, scarring, and wound infection. This review paper discusses recent advances in the development of biomaterials and nanoparticle therapeutics to enhance wound healing. In particular, this review focuses on the novel cutaneous wound treatments that have undergone significant preclinical development or are currently used in clinical practice.

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Section: Biomaterial-based Wound Therapiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

Baker

2016

Front. Bioeng. Biotechnol.

233

196

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“…Diabetes mellitus (DM) is a syndrome characterized by hyperglycemia that results from absolute or relative impairment in insulin secretion and/or insulin action 1. With the development of people’s living standards and lifestyle changes, the incidence of diabetes has been rising.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of negative-pressure wound therapy for patients with diabetic foot ulcers: systematic review and meta-analysis

Liu¹,

He²,

Cai³

et al. 2017

TCRM

101

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ObjectivesThe aim of this study was to perform an updated systematic review and meta-analysis to assess the clinical efficacy, safety, and cost-effectiveness of negative-pressure wound therapy (NPWT) in the treatment of diabetic foot ulcers (DFUs).MethodsWe searched the Cochrane Library, MEDLINE, EMBASE, Ovid, and Chinese Biological Medicine databases up to June 30, 2016. We also manually searched the articles from reference lists of the retrieved articles, which used the NPWT system in studies of vacuum-assisted closure therapy. Studies were identified and selected, and two independent reviewers extracted data from the studies.ResultsA total of eleven randomized controlled trials, which included a total of 1,044 patients, were selected from 691 identified studies. Compared with standard dressing changes, NPWT had a higher rate of complete healing of ulcers (relative risk, 1.48; 95% confidence interval [CI]: 1.24–1.76; P<0.001), shorter healing time (mean difference, −8.07; 95% CI: −13.70– −2.45; P=0.005), greater reduction in ulcer area (mean difference, 12.18; 95% CI: 8.50–15.86; P<0.00001), greater reduction in ulcer depth (mean difference, 40.82; 95% CI: 35.97–45.67; P<0.00001), fewer amputations (relative risk, 0.31; 95% CI: 0.15–0.62; P=0.001), and no effect on the incidence of treatment-related adverse effects (relative risk, 1.12; 95% CI: 0.66–1.89; P=0.68). Meanwhile, many analyses showed that the NPWT was more cost-effective than standard dressing changes.ConclusionThese results indicate that NPWT is efficacious, safe, and cost-effective in treating DFUs.

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“…BM-MSCs have demonstrated in a number of chronic wound patients (but not in all patients) to augment wound healing by reduction of inflammation, promotion of angiogenesis, acceleration of reepithelialization and inhibition of apoptosis of wound healing cells. However, it is not clear whether these effects are mediated through cellular differentiation and/or by secretion of cytokines and growth factors from the BM-MSCs [2,47,48]. BM-MSCs are relatively easy to isolate and studies have suggested minimal immunogenic response when allogeneic cells are used [48].…”

Section: Bone Marrow-derived Mesenchymal Stem Cellsmentioning

confidence: 99%

“…In the US alone, chronic wounds affect > 6 million patients annually, costing the health care system an estimated US$ 20 --25 billion [1]. On a global scale, > 380 million people suffer from diabetes, with approximately 15% of them having a diabetic foot ulcer which is responsible for approximately 80% of all lower leg amputations [2]. Despite this high incidence and heavy economic burden, current treatment of chronic wounds is far from effective and novel therapies are in urgent need.…”

Section: Introductionmentioning

confidence: 99%

Advances in the treatment of chronic wounds: a patent review

Koppen¹,

Hartmann

2015

Expert Opinion on Therapeutic Patents

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The aforementioned biological agents have different mechanisms of action, and considering the multifactorial pathogenesis of chronic wounds, they hold promise in treating chronic wounds. However, as administration of a certain biological agent may be beneficial in an early phase, it may slow down wound healing in a later phase. Basic and clinical research on chronic wound healing should therefore investigate the efficacy of these agents, alone and in concert, during the consecutive phases of wound healing.

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Preclinical and clinical evidence for stem cell therapies as treatment for diabetic wounds

Cited by 37 publications

References 135 publications

Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

Evaluation of negative-pressure wound therapy for patients with diabetic foot ulcers: systematic review and meta-analysis

Advances in the treatment of chronic wounds: a patent review

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