Regenerative Medicine Institute (REMEDI), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.
Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.
Stem Cell Res Ther. 2022 Aug 20;13(1):426. doi: 10.1186/s13287-022-03115-4.
Foot ulceration is a major complication of diabetes mellitus, which results in significant human suffering and a major burden on healthcare systems. The cause of impaired wound healing in diabetic patients is multifactorial with contributions from hyperglycaemia, impaired vascularization and neuropathy. Patients with non-healing diabetic ulcers may require amputation, creating an urgent need for new reparative treatments. Delivery of stem cells may be a promising approach to enhance wound healing because of their paracrine properties, including the secretion of angiogenic, immunomodulatory and anti-inflammatory factors. While a number of different cell types have been studied, the therapeutic use of mesenchymal stromal cells (MSCs) has been widely reported to improve delayed wound healing. However, topical administration of MSCs via direct injection has several disadvantages, including low cell viability and poor cell localization at the wound bed. To this end, various biomaterial conformations have emerged as MSC delivery vehicles to enhance cell viability and persistence at the site of implantation. This paper discusses biomaterial-based MSCs therapies in diabetic wound healing and highlights the low conversion rate to clinical trials and commercially available therapeutic products.
足部溃疡是糖尿病的一种主要并发症，给患者带来极大的痛苦，也给医疗系统带来了沉重负担。糖尿病患者伤口愈合受损的原因是多方面的，包括高血糖、血管化受损和神经病变。对于那些无法愈合的糖尿病溃疡患者，可能需要截肢，这就迫切需要新的修复治疗方法。干细胞的输送可能是一种很有前途的增强伤口愈合的方法，因为它们具有旁分泌特性，包括分泌血管生成、免疫调节和抗炎因子。虽然已经研究了许多不同的细胞类型，但间充质基质细胞 (MSCs) 的治疗用途已被广泛报道可改善延迟的伤口愈合。然而，通过直接注射将 MSCs 局部给药有几个缺点，包括细胞活力低和在伤口床处的细胞定位不佳。为此，各种基于生物材料的 MSC 输送载体已经出现，以提高细胞在植入部位的活力和持久性。本文讨论了基于生物材料的 MSC 治疗在糖尿病性伤口愈合中的应用，并强调了其转化为临床试验和商业上可获得的治疗产品的低转化率。
