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Review
. 2023 Mar 16:14:1099310.
doi: 10.3389/fendo.2023.1099310. eCollection 2023.

Function and mechanism of mesenchymal stem cells in the healing of diabetic foot wounds

Xiaoping Yu  1 , Pan Liu  2 , Zheng Li  3 , Zhengdong Zhang  4   5
Affiliations
Review

Function and mechanism of mesenchymal stem cells in the healing of diabetic foot wounds

Xiaoping Yu et al. Front Endocrinol (Lausanne). .

Abstract

Diabetes has become a global public health problem. Diabetic foot is one of the most severe complications of diabetes, which often places a heavy economic burden on patients and seriously affects their quality of life. The current conventional treatment for the diabetic foot can only relieve the symptoms or delay the progression of the disease but cannot repair damaged blood vessels and nerves. An increasing number of studies have shown that mesenchymal stem cells (MSCs) can promote angiogenesis and re-epithelialization, participate in immune regulation, reduce inflammation, and finally repair diabetic foot ulcer (DFU), rendering it an effective means of treating diabetic foot disease. Currently, stem cells used in the treatment of diabetic foot are divided into two categories: autologous and allogeneic. They are mainly derived from the bone marrow, umbilical cord, adipose tissue, and placenta. MSCs from different sources have similar characteristics and subtle differences. Mastering their features to better select and use MSCs is the premise of improving the therapeutic effect of DFU. This article reviews the types and characteristics of MSCs and their molecular mechanisms and functions in treating DFU to provide innovative ideas for using MSCs to treat diabetic foot and promote wound healing.

Keywords: Angiogenesis; Diabetic foot; Mesenchymal stem cells; Wound healing; mechanism.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The route of administration for mesenchymal stem cells therapy. Mesenchymal stem cells are mainly used for the treatment of diabetic foot by local delivery and systemic delivery. Local delivery is divided into topical application, topical injection, scaffold, gel and so on; systemic delivery is divided into intravenous administration and arterial administration.
Figure 2
Figure 2
The effect of mesenchymal stem cells on tissue damage through immune regulation. Mesenchymal stem cells participate in immune regulation by inhibiting T17 and T1 cells, promoting Treg cells, downregulating ROS, and accelerating the polarization of M2, so as to reduce inflammation and repair the damage of diabetic foot. (Created in BioRender.com).
Figure 3
Figure 3
The therapeutic mechanism of mesenchymal stem cells (MSCs) for diabetic foot. MSCs are mainly derived from bone marrow, umbilical cord, adipose tissue, placenta, and other parts. During the treatment of diabetic foot, mesenchymal stem cells repair diabetic foot mainly through the proliferation of fibroblasts, keratinocytes and endothelial cells, as well as angiogenesis and polarization of macrophage M2. In this process, paracrine growth factors, related signaling pathways and microRNAs are involved. (Created in BioRender.com).
See this image and copyright information in PMC

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