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

Helal F Hetta; Alaa Elsaghir; Victor Coll Sijercic; Mahad S Akhtar; Sayed A Gad; Avinash Moses; Mahlet S Zeleke; Fawaz E Alanazi; Abdulrahman K Ahmed; Yasmin N Ramadan

doi:10.1002/hsr2.2036

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

Health Sci Rep. 2024 Apr 21;7(4):e2036. doi: 10.1002/hsr2.2036. eCollection 2024 Apr.

Authors

Affiliations

¹ Division of Microbiology, Immunology and Biotechnology, Department of Natural Products and Alternative Medicine Faculty of Pharmacy, University of Tabuk Tabuk Saudi Arabia.
² Department of Medical Microbiology and Immunology Faculty of Medicine, Assiut University Assiut Egypt.
³ Department of Microbiology and Immunology Faculty of Pharmacy, Assiut University Assiut Egypt.
⁴ North Central College Naperville Illinois USA.
⁵ Faculty of Medicine, Assiut University Assiut Egypt.
⁶ Menelik II Medical and Health Science College, Kotebe Metropolitan University Addis Ababa Ethiopia.
⁷ Department of Pharmacology and Toxicology Faculty of Pharmacy, University of Tabuk Tabuk Saudi Arabia.

Abstract

Background: Diabetes 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.

Methodology: A 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 discussion: Numerous 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.

Conclusion: The 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.

Keywords: cell therapy; diabetes; diabetic foot ulcers (DFU); mesenchymal stem cell; wound healing.