Three-week topical treatment with placenta-derived mesenchymal stem cells hydrogel in a patient with diabetic foot ulcer

Abstract

Rationale:Diabetic foot ulcer (DFU) is a chronic complication of diabetes characterized by continuity, repeatability, and nonhealing. In recent years, mesenchymal stem cells hydrogel complex has been a new emerging technique in the treatment of DFU. The placenta-derived mesenchymal stem cells (PDMSCs) hydrogel is multipotent, and can secrete growth factors, cytokines, and immunomodulatory substances which could accelerate wound healing.Patient concerns:In this case report, we present a 57-year-old female with type 2 diabetes mellitus and a 20-day DFU.A wound bed located at the dorsalis pedis of the right foot, and conventional therapies had no effect on the foot.Diagnoses:The patient was confirmed a diagnosis of type 2 DM with diabetic foot (Wagner classification III).Interventions:To assess the efficacy and safety of PDMSCs hydrogel in wound repair and to improve the rate of wound healing, we administered PDMSCs hydrogel (cell number: 1 × 106/cells/cm2) topically into the wound with the patient's permission.Outcomes:The patient's foot ulcer was almost healed, and foot function in walking was well preserved. No complications were observed. No recurrence occurred in the subsequent 6 months.Lessons:To the best of our knowledge, this is the first patient globally to receive PDMSCs hydrogel to treat DFU. The present case study suggests that PDMSCs hydrogel may provide a new approach to DFU treatment. Clinical Trial Registration-URL: http://www.chictr.org.cn/searchproj.aspx:chiCRT-ONC-16008732.

Safety and Efficacy of Placenta-Derived Mesenchymal Stem Cell Treatment for Diabetic Patients with Critical Limb Ischemia: A Pilot Study

“…P-MSCs were kindly provided by the Stem Cell Engineering Research Center of Jiangxi Province (Shangrao, China). P-MSCs were isolated based on methods previously described [9][10][11]. Briefly, human placenta was obtained from full-term delivery with written informed consent of healthy mother.…”

Advanced hydrogels for treatment of diabetes

“…Recently, an alginate gel loaded with one million placenta-derived mesenchymal stem cells (PDMSCs) induced wound healing in a female 57-year-old patient presenting with a 20-day DFU. This approach relies on the ability of PDMSCs to produce VEGF, bFGF, and EGF involved in wound repair (Zeng et al, 2017). This watershed investigation is a call to continue testing PDMSCs in a larger population of patients having similar DFU stage affection.…”

Regenerative therapy for the nonhealing cutaneous wounds

“…Proangiogenic endothelial progenitor cells have also been shown to improve healing in cutaneous wounds by enhancing the neovascularization of granulation tissue in vivo [25]. Placental MSCs have a potential for the treatment of chronic wounds, since they have a number of advantages over other stem cells: (a) possess more pronounced immunomodulating effect and (b) higher proliferation rates; (c) demonstrate lower immunogenicity; (d) can differentiate into various cell linea ges [19,26].…”

“…Currently, there are a few finished clinical trials of SCs in the treatment of wounds, ulcers and burns. For example, the successful treatment of diabetic foot ulcer using the placental MSCs, incorporated in a sodium alginate hydrogel, has been achieved recently [26]. The progress in the clinical trials of novel MSCbased technologies can be followed at the National Institute of Health web-site www.…”