Moldovan Cezara-Anca-Denisa, Salagean Alex-Adrian, Slevin Mark
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.
Department of Histology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.
Gels. 2025 Jun 3;11(6):430. doi: 10.3390/gels11060430.
Diabetic foot ulcers (DFU) represent a major complication of diabetes mellitus, affecting millions of patients worldwide and leading to high morbidity and amputation risks. The impaired healing process in DFU is driven by vascular insufficiency, neuropathy, chronic inflammation, and infections. Conventional treatments, including blood sugar control, wound debridement, and standard dressings, have shown limited efficacy in achieving complete healing. Recent advancements have introduced novel therapeutic approaches such as stem cell therapy, exosome-based treatments, and bioengineered scaffolds to accelerate wound healing and tissue regeneration. Mesenchymal stem cells (MSCs), particularly adipose-derived stem cells (ASCs), exhibit anti-inflammatory, pro-angiogenic, and immunomodulatory properties, enhancing wound repair. Additionally, exosomes derived from ASCs have demonstrated the ability to promote fibroblast proliferation, regulate inflammation, and stimulate angiogenesis. The integration of bioengineered scaffolds, including hydrogels, hyaluronic acid (HA), or micro-fragmented adipose tissue (MFAT), offers improved drug delivery mechanisms and a controlled healing environment. These scaffolds have been successfully utilized to deliver stem cells, growth factors, antioxidants, anti-glycation end products, anti-inflammatory and anti-diabetic drugs, or antimicrobial agents, further improving DFU outcomes. This review highlights the potential of combining novel 3D scaffolds with anti-diabetic drugs to enhance DFU treatment, reduce amputation rates, and improve patients' quality of life. While promising, further clinical research is required to validate these emerging therapies and optimize their clinical application.
糖尿病足溃疡（DFU）是糖尿病的一种主要并发症，影响着全球数百万患者，并导致高发病率和截肢风险。DFU中受损的愈合过程是由血管功能不全、神经病变、慢性炎症和感染驱动的。包括血糖控制、伤口清创和标准敷料在内的传统治疗方法在实现完全愈合方面显示出有限的疗效。最近的进展引入了新的治疗方法，如干细胞疗法、基于外泌体的治疗方法和生物工程支架，以加速伤口愈合和组织再生。间充质干细胞（MSCs），特别是脂肪来源的干细胞（ASCs），具有抗炎、促血管生成和免疫调节特性，可促进伤口修复。此外，源自ASCs的外泌体已证明具有促进成纤维细胞增殖、调节炎症和刺激血管生成的能力。生物工程支架的整合，包括水凝胶、透明质酸（HA）或微片段化脂肪组织（MFAT），提供了改进的药物递送机制和可控的愈合环境。这些支架已成功用于递送干细胞、生长因子、抗氧化剂、抗糖基化终产物、抗炎和抗糖尿病药物或抗菌剂，进一步改善了DFU的治疗效果。这篇综述强调了将新型3D支架与抗糖尿病药物相结合以增强DFU治疗、降低截肢率和改善患者生活质量的潜力。虽然前景广阔，但需要进一步的临床研究来验证这些新兴疗法并优化其临床应用。
