Department of hand and foot surgery, Jinhua Hospital of Zhejiang University, Jinhua, People's Republic of China.
Department of hand and foot surgery, Jinhua Central Hospital, 365 Renmin East Road, Jinhua, Zhejiang Province, People's Republic of China.
Stem Cell Rev Rep. 2021 Apr;17(2):369-378. doi: 10.1007/s12015-020-10014-9.
Diabetic foot ischemia and ulcer (DFU) persists as a serious diabetes mellitus complication in spite of increased understanding of the pathophysiology and the cellular and molecular responses. Contributing to this pessimistic situation is the lack of effective treatments that are slow to heal the deep chronic wounds and microvascular obstruction. Mesenchymal stromal cells (MSCs) have been tested as a promising cell-based therapy for diabetes in vitro and in vivo, which is able to accelerate wound closure with increased epithelialization, granulation tissue formation and angiogenesis by differentiation into skin cells and paracrine pathways to repair injured cells. The secretomes of MSCs, including cytokines, growth factors, chemokines, and extracellular vesicles containing mRNA, proteins and microRNAs, have immunomodulatory and regenerative effects. This review will shed new light on the therapeutic potential of MSC-derived extracellular vesicles (MSC-EVs) for the treatment of diabetes-induced lower limb ischemia and ulcers. The identification of underlying mechanisms for MSC-EVs regulation on impaired diabetic wound healing might provide a new direction for MSC-centered treatment for diabetic lower limb ischemia and ulcers. Immunomodulatory and angiogenic effects of MSC-derived extracellular vesicles on diabetic foot ulcer.
糖尿病足缺血性溃疡（DFU）尽管对其病理生理学和细胞及分子反应有了更深入的了解，但仍然是糖尿病的一种严重并发症。导致这种悲观局面的原因是缺乏有效的治疗方法，这些方法治疗深部慢性伤口和微血管阻塞的速度缓慢。间充质基质细胞（MSC）已被测试作为一种有前途的基于细胞的糖尿病治疗方法，无论是在体外还是体内，都能够通过分化为皮肤细胞和旁分泌途径来加速伤口闭合，增加上皮化、肉芽组织形成和血管生成，从而修复受损细胞。MSC 的分泌组，包括细胞因子、生长因子、趋化因子和含有 mRNA、蛋白质和 microRNAs 的细胞外囊泡，具有免疫调节和再生作用。这篇综述将为 MSC 衍生的细胞外囊泡（MSC-EVs）在治疗糖尿病诱导的下肢缺血和溃疡方面的治疗潜力提供新的视角。确定 MSC-EVs 对受损糖尿病创面愈合的调节作用的潜在机制，可能为以 MSC 为中心的糖尿病下肢缺血和溃疡治疗提供新的方向。MSC 衍生的细胞外囊泡对糖尿病足溃疡的免疫调节和血管生成作用。
