Abstract
Chronic wounds fail to heal through the three normal stages of healing (inflammatory,
proliferative, and remodelling), resulting in a chronic tissue injury that is not
repaired within the average time limit. Patients suffering from type 1 and type 2
diabetes are prone to develop diabetic foot ulcers (DFUs), which commonly develop
into chronic wounds that are non treatable with conventional therapies. DFU develops
due to various risk factors, such as peripheral neuropathy, peripheral vascular disease,
arterial insufficiency, foot deformities, trauma and impaired resistance to infection.
DFUs have gradually become a major problem in the health care system worldwide. In
this review, we not only focus on the pathogenesis of DFU but also comprehensively
summarize the outcomes of preclinical and clinical studies thus far and the potential
therapeutic mechanism of bone marrow-derived mesenchymal stem cells (BMSCs) for the
treatment of DFU. Based on the published results, BMSC transplantation can contribute
to wound healing through growth factor secretion, anti-inflammation, differentiation
into tissue-specific cells, neovascularization, re-epithelialization and angiogenesis
in DFUs. Moreover, clinical trials showed that BMSC treatment in patients with diabetic
ulcers improved ulcer healing and the ankle-brachial index, ameliorated pain scores,
and enhanced claudication walking distances with no reported complications. In conclusion,
although BMSC transplantation exhibits promising therapeutic potential in DFU treatment,
additional studies should be performed to confirm their efficacy and long-term safety
in DFU patients.
Keywords
Abbreviations:
DFU (Diabetic foot ulcer), BMSCs (Bone marrow-derived mesenchymal stem cells), PN (Peripheral neuropathy), PVD (Peripheral vascular disease), MSCs (Mesenchymal stem cells), IGF-1 (Insulin like growth factor 1), KGF (Keratinocyte growth factor), EGF (Epidermal growth factor), SDF-1 (stromal cell-derived factor1), EPO (Erythropoietin), PECAM-1 (Platelet endothelial cell adhesion molecule-1), NGF (Nerve growth factor), PDGF (Platelet-derived growth factor BB), HGF (Hepatocyte growth factor), BDNF (Brain-derived neurotropic factor), bFGF (Basic fibroblast growth factor), ANG-2 (Plasma angiopoietin-2), VCAM1 (Vascular adhesion molecule 1-), ICAM1 (Intercellular adhesion molecule 1-), BMSC-CM (Bone marrow derived mesenchymal stem cells derived conditioned medium), C–C (chemokine receptor type 7 (CCR7)), CXCR4 (C-X-C Motif Chemokine Receptor 4), TSG-6 (Tumor necrosis factor- (TNF) stimulated gene-6)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 06, 2022
Accepted:
December 1,
2022
Received in revised form:
August 31,
2022
Received:
February 20,
2022
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