Sriphan Pongpol, Chruewkamlow Nuttapol, Sathan-Ard Chutipon, Phutthakunphithak Phakawan, Sampattavanich Somponnat, Anekpuritanang Tauangtham, Sakamula Romgase, Likhityungyuen Thanaphon, Wongwanit Chumpol, Ruangsetakit Chanean, Sermsathanasawadi Nuttawut
Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Int Wound J. 2025 Apr;22(4):e70106. doi: 10.1111/iwj.70106.
This study set forth to investigate the efficacy of Quality and Quantity mononuclear cells (QQMNCs) for promoting wound healing and limb salvage in a severe ischemic wound model using diabetic mice. Female BALB/c nude mice induced with diabetes were used to create ischemic limb models in a controlled experimental design. Intramuscular injections of human QQMNCs were compared to phosphate-buffered saline (PBS) and peripheral blood mononuclear cells (PBMNCs) relative to their effects on wound healing and limb salvage. In vitro analysis demonstrated that the QQMNC group had significantly higher median percentages of CD34+ cells, CD34+CD133+ cells, CD206+ cells, and FOXP3+ cells compared to the PBMNC group (all p < 0.05), which suggests an enhanced regenerative and immunomodulatory profile. Kaplan-Meier survival analysis showed a significantly higher number of completely healed wounds in the QQMNC group than in the PBMNC group (p = 0.044). The histological evaluation showed that the QQMNC group had a significantly thinner epithelial thickness than the PBMNC (p = 0.032) and PBS groups (p = 0.002), and a significantly greater T cell density than the PBS group (p = 0.033), which suggests more efficient tissue repair. Moreover, the QQMNC group exhibited the highest percentage of minor tissue loss (57% for forefoot and toe gangrene), and the lowest incidence of severe limb loss (0% for lower leg gangrene). The findings of this study highlight the effectiveness of QQMNCs for promoting wound healing and limb salvage in diabetic ischemic animal model; however, clinical trials are needed to further assess their efficacy in this clinical context.
本研究旨在探讨优质定量单核细胞（QQMNCs）在使用糖尿病小鼠的严重缺血性伤口模型中促进伤口愈合和肢体挽救的疗效。采用雌性BALB/c裸鼠诱导糖尿病，在对照实验设计中建立缺血肢体模型。将肌肉注射人QQMNCs与磷酸盐缓冲盐水（PBS）和外周血单核细胞（PBMNCs）在伤口愈合和肢体挽救方面的效果进行比较。体外分析表明，与PBMNC组相比，QQMNC组中CD34+细胞、CD34+CD133+细胞、CD206+细胞和FOXP3+细胞的中位数百分比显著更高（均p<0.05），这表明其再生和免疫调节能力增强。Kaplan-Meier生存分析显示，QQMNC组完全愈合的伤口数量显著多于PBMNC组（p = 0.044）。组织学评估表明，QQMNC组的上皮厚度显著薄于PBMNC组（p = 0.032）和PBS组（p = 0.002），且T细胞密度显著高于PBS组（p = 0.033），这表明组织修复更有效。此外，QQMNC组的轻微组织损失百分比最高（前足和趾坏疽为57%），严重肢体损失的发生率最低（小腿坏疽为0%）。本研究结果突出了QQMNCs在糖尿病缺血动物模型中促进伤口愈合和肢体挽救的有效性；然而，需要进行临床试验以进一步评估其在这种临床情况下的疗效。
