在明胶静电纺丝纳米纤维支架加富血小板血浆凝胶中使用人胎盘来源的间充质干细胞改善糖尿病足溃疡的伤口愈合：一项随机临床试验。

Improved wound healing of diabetic foot ulcers using human placenta-derived mesenchymal stem cells in gelatin electrospun nanofibrous scaffolds plus a platelet-rich plasma gel: A randomized clinical trial.

作者信息

Meamar Rokhsareh, Ghasemi-Mobarakeh Laleh, Norouzi Mohammad-Reza, Siavash Mansour, Hamblin Michael R, Fesharaki Mehrafarin

机构信息

Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Textile Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran.

出版信息

Int Immunopharmacol. 2021 Dec;101(Pt B):108282. doi: 10.1016/j.intimp.2021.108282. Epub 2021 Oct 28.

DOI:10.1016/j.intimp.2021.108282

PMID:34737130

Abstract

AIM

The effectiveness of nanofibers containing human placenta-derived mesenchymal stem cells (hPDMSCs) plus platelet-rich plasma (PRP) for healing of diabetic foot ulcers (DFUs) was investigated.

METHODS

hPDMSCs were isolated from human donor placentas, and cultured in electrospun gelatin nanofibrous scaffolds (GNS). Twenty-eight patients with DFUs were randomized into three groups in a 12-week trial: (A) Treated with hPDMSCs; (B) Treated with hPDMSCs after coating the ulcer with PRP gel; (C) Control group received standard wound care. Wound area and pain freewalkingdistance were measured every 2 weeks.

RESULTS

Flow cytometry showed the expression of mesenchymal markers. SEM images and DAPI staining indicated significantly higher levels of hPDMSC proliferation on GNS after 3 and 7 days of culture. The MTS assay showed a significant increase in proliferation on GNS, compared to controls. Wound size reduction was 66% in group A, 71% in group B, and 36% in control group C. A significant difference in wound closure and pain-free walking distance was observed between groups A and B, compared to control group C (p < 0.05), but no difference between groups A and B. Biopsy of the implanted tissue showed the development of new capillary formation in groups A and B.

CONCLUSION

Implantation of hPDMSCs in GNS accelerated wound healing and improved clinical parameters in DFU patients.

摘要

目的

研究含人胎盘间充质干细胞（hPDMSCs）和富血小板血浆（PRP）的纳米纤维对糖尿病足溃疡（DFU）愈合的有效性。

方法

从人供体胎盘中分离出hPDMSCs，并在静电纺丝明胶纳米纤维支架（GNS）中培养。28例DFU患者在为期12周的试验中被随机分为三组：（A）用hPDMSCs治疗；（B）用PRP凝胶覆盖溃疡后再用hPDMSCs治疗；（C）对照组接受标准伤口护理。每2周测量伤口面积和无痛步行距离。

结果

流式细胞术显示间充质标志物的表达。扫描电子显微镜图像和4',6-二脒基-2-苯基吲哚染色表明，培养3天和7天后，GNS上hPDMSC的增殖水平显著更高。与对照组相比，MTS试验显示GNS上的增殖显著增加。A组伤口大小减少66%，B组减少71%，C组对照组减少36%。与C组对照组相比，A组和B组在伤口闭合和无痛步行距离方面存在显著差异（p<0.05），但A组和B组之间无差异。植入组织活检显示A组和B组有新的毛细血管形成。