Towards Reaching the Target: Clinical Application of Mesenchymal Stem Cells for Diabetic Foot Ulcers

Abstract

Mesenchymal stem cells (MSCs) hold great promise for therapeutic application in non-healing ulcers and tissue regeneration because of their multi-lineage differentiation potential. MSCs delivered may migrate to the sites of injury and improve wound healing by stimulating angiogenesis and promoting revascularization. The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide. It is associated with peripheral neuropathy and peripheral arterial occlusive disease (PAOD), which predispose patients to develop non-healing foot ulcers following minor trauma. A high rate of amputation exists among diabetic patients due to non-healing foot ulcers, which are a significant burden for the society despite new therapeutic protocols developed. In recent years, stem cell transplantation has been considered as a new therapeutic option for diabetic foot ulcers (DFUs). The regeneration potential of MSCs has been demonstrated in the experimental and clinical trials. Here we review the potential efficacy and systematic use of MSCs for the treatment of non-healing DFUs, current advances, MSC delivery systems, and possible options to enhance the therapeutic potential of stem cell for wound healing.

Pathogenesis of wound healing disorders in the elderly

“…MSCs promote angiogenesis and migration, and they have the ability to induce regeneration rather than fi brosis in the wound microenvironment [91][92][93] . In diabetic animal models, systemic or local injections, for example, of both MSCs promote angiogenesis and migration, and they have the ability to induce regeneration rather than fi brosis in the wound microenvironment.…”

Diabetes Mellitus and Regenerative Medicine: New Possibilities for the Regeneration of β Cells and Treatment of Diabetic Foot Ulcer

“…Moreover, studies on possibility of utilizing MSCs in regenerative and reparative therapies for neurological disorders particularly Parkinsonism are underway. Furthermore, human mesenchymal stem cells have great potential for tissue engineering but the challenge remains always to generate functional cell types that are useful for transplantation [25,26].…”

VEGF gene transfected umbilical cord mesenchymal stem cells transplantation improve the lower limb vascular lesions of diabetic rats

“…Diabetes patients face serious complications that may affect the eyes, feet, skin, kidneys and heart (Dash, Dash, Guru, et al, 2014). Foot ulceration is one of the most common complications in diabetes mellitus patients.…”

“…Advanced T2DM is associated with significant morbidity and mortality due to cardiovascular, nervous and renal complications. Diabetes is an important risk factor for peripheral arterial disease, the limb amputation risk for diabetic patients is very high, and diabetes is the main cause of renal failure and blindness in many countries (Dash, Dash, Guru, & Mohapatra, 2014). In fact, most of diabetic patients develop hypertension and cardiovascular diseases, as is the reason of morbidity and mortality among adult patients (Li et al, 2013).…”