Adipose-derived Stem Cells in Diabetic Foot Care: Bridging Clinical Trials and Practical Application

Overview

Journal World J Diabetes

Publisher Baishideng Publishing Group

Specialty Endocrinology

Date 2024 Jul 10

PMID 38983804

Authors

Song-Lu Tseng

Lin Kang

Zhu-Jun Li

Li-Quan Wang

Zi-Ming Li

Tian-Hao Li

Jie-Yu Xiang

Jiu-Zuo Huang

Nan-Ze Yu

Xiao Long

Affiliations

Soon will be listed here.

Abstract

Diabetic foot ulcers (DFUs) pose a critical medical challenge, significantly im-pairing the quality of life of patients. Adipose-derived stem cells (ADSCs) have been identified as a promising therapeutic approach for improving wound healing in DFUs. Despite extensive exploration of the mechanical aspects of ADSC therapy against DFU, its clinical applications remain elusive. In this review, we aimed to bridge this gap by evaluating the use and advancements of ADSCs in the clinical management of DFUs. The review begins with a discussion of the classification and clinical management of diabetic foot conditions. It then discusses the current landscape of clinical trials, focusing on their geographic distribution, reported efficacy, safety profiles, treatment timing, administration techniques, and dosing considerations. Finally, the review discusses the preclinical strategies to enhance ADSC efficacy. This review shows that many trials exhibit biases in study design, unclear inclusion criteria, and intervention protocols. In conclusion, this review underscores the potential of ADSCs in DFU treatment and emphasizes the critical need for further research and refinement of therapeutic approaches, with a focus on improving the quality of future clinical trials to enhance treatment outcomes and advance the field of diabetic wound care.

References

Naderi N, Combellack E, Griffin M, Sedaghati T, Javed M, Findlay M . The regenerative role of adipose-derived stem cells (ADSC) in plastic and reconstructive surgery. Int Wound J. 2016; 14(1):112-124. PMC: 7949873. DOI: 10.1111/iwj.12569. View

Chen B, Wei Y, Cai J, Zitkovsky H, Guo L . Comparable Effects on Healing between Autologous Diabetic Adipose-Derived Stem Cells and Allogeneic Normal Counterparts. Plast Reconstr Surg. 2023; 153(2):379-388. DOI: 10.1097/PRS.0000000000010647. View

Jais S . Various Types of Wounds That Diabetic Patients Can Develop: A Narrative Review. Clin Pathol. 2023; 16:2632010X231205366. PMC: 10566271. DOI: 10.1177/2632010X231205366. View

Pinzur M, Shields N, Goelitz B, Slovenkai M, Kaye R, Ross S . American Orthopaedic Foot and Ankle Society shoe survey of diabetic patients. Foot Ankle Int. 1999; 20(11):703-7. DOI: 10.1177/107110079902001105. View

Ince P, Abbas Z, Lutale J, Basit A, Ali S, Chohan F . Use of the SINBAD classification system and score in comparing outcome of foot ulcer management on three continents. Diabetes Care. 2008; 31(5):964-7. DOI: 10.2337/dc07-2367. View

Kavanagh H, Mahon B . Allogeneic mesenchymal stem cells prevent allergic airway inflammation by inducing murine regulatory T cells. Allergy. 2010; 66(4):523-31. DOI: 10.1111/j.1398-9995.2010.02509.x. View

Varghese J, Griffin M, Mosahebi A, Butler P . Systematic review of patient factors affecting adipose stem cell viability and function: implications for regenerative therapy. Stem Cell Res Ther. 2017; 8(1):45. PMC: 5329955. DOI: 10.1186/s13287-017-0483-8. View

Fallahi F, Mostafavinia A, Sharifi Z, Mohaghegh Shalmani L, Amini A, Ahmadi H . Effects of photobiomodulation on mitochondrial function in diabetic adipose-derived stem cells in vitro. Spectrochim Acta A Mol Biomol Spectrosc. 2022; 285:121835. DOI: 10.1016/j.saa.2022.121835. View

Mazini L, Rochette L, Amine M, Malka G . Regenerative Capacity of Adipose Derived Stem Cells (ADSCs), Comparison with Mesenchymal Stem Cells (MSCs). Int J Mol Sci. 2019; 20(10). PMC: 6566837. DOI: 10.3390/ijms20102523. View

10.

Song Y, You Y, Xu X, Lu J, Huang X, Zhang J . Adipose-Derived Mesenchymal Stem Cell-Derived Exosomes Biopotentiated Extracellular Matrix Hydrogels Accelerate Diabetic Wound Healing and Skin Regeneration. Adv Sci (Weinh). 2023; 10(30):e2304023. PMC: 10602544. DOI: 10.1002/advs.202304023. View

11.

Nilforoushzadeh M, Sisakht M, Amirkhani M, Seifalian A, Banafshe H, Verdi J . Engineered skin graft with stromal vascular fraction cells encapsulated in fibrin-collagen hydrogel: A clinical study for diabetic wound healing. J Tissue Eng Regen Med. 2019; 14(3):424-440. DOI: 10.1002/term.3003. View

12.

Lepantalo M, Apelqvist J, Setacci C, Ricco J, de Donato G, Becker F . Chapter V: Diabetic foot. Eur J Vasc Endovasc Surg. 2011; 42 Suppl 2:S60-74. DOI: 10.1016/S1078-5884(11)60012-9. View

13.

Ebrahim N, Dessouky A, Mostafa O, Hassouna A, Yousef M, Seleem Y . Adipose mesenchymal stem cells combined with platelet-rich plasma accelerate diabetic wound healing by modulating the Notch pathway. Stem Cell Res Ther. 2021; 12(1):392. PMC: 8276220. DOI: 10.1186/s13287-021-02454-y. View

14.

Hermann M, Peddi A, Gerhards A, Schmid R, Schmitz D, Arkudas A . Secretome of Adipose-Derived Stem Cells Cultured in Platelet Lysate Improves Migration and Viability of Keratinocytes. Int J Mol Sci. 2023; 24(4). PMC: 9962933. DOI: 10.3390/ijms24043522. View

15.

Yang Y, Chen X, Li F, Chen Y, Gu L, Zhu J . In vitro induction of human adipose-derived stem cells into lymphatic endothelial-like cells. Cell Reprogram. 2015; 17(1):69-76. DOI: 10.1089/cell.2014.0043. View

16.

Nolan G, Smith O, Heavey S, Jell G, Mosahebi A . Histological analysis of fat grafting with platelet-rich plasma for diabetic foot ulcers-A randomised controlled trial. Int Wound J. 2021; 19(2):389-398. PMC: 8762540. DOI: 10.1111/iwj.13640. View

17.

Yang H, Fierro F, So M, Yoon D, Nguyen A, Gallegos A . Combination product of dermal matrix, human mesenchymal stem cells, and timolol promotes diabetic wound healing in mice. Stem Cells Transl Med. 2020; 9(11):1353-1364. PMC: 7581456. DOI: 10.1002/sctm.19-0380. View

18.

Kress G, Swerdlow M, Mohan N, Patel K, Shin L . Remission Strategies with Fat Grafting to Prevent Recurrence of Pedal Ulcerations and Pain: A Case Series. Plast Reconstr Surg Glob Open. 2023; 11(9):e5232. PMC: 10473342. DOI: 10.1097/GOX.0000000000005232. View

19.

Chen P, Vilorio N, Dhatariya K, Jeffcoate W, Lobmann R, McIntosh C . Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev. 2023; 40(3):e3644. DOI: 10.1002/dmrr.3644. View

20.

Gholamrezanezhad A, Mirpour S, Bagheri M, Mohamadnejad M, Alimoghaddam K, Abdolahzadeh L . In vivo tracking of 111In-oxine labeled mesenchymal stem cells following infusion in patients with advanced cirrhosis. Nucl Med Biol. 2011; 38(7):961-7. DOI: 10.1016/j.nucmedbio.2011.03.008. View