Tseng SL, Kang L, Li ZJ, Wang LQ, Li ZM, Li TH, Xiang JY, Huang JZ, Yu NZ, Long X. Adipose-derived stem cells in diabetic foot care: Bridging clinical trials and practical application. World J Diabetes 2024; 15(6): 1162-1177 [DOI: 10.4239/wjd.v15.i6.1162]
Corresponding Author of This Article
Xiao Long, MD, PhD, Chief Physician, Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. pumclongxiao@126.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jun 15, 2024; 15(6): 1162-1177 Published online Jun 15, 2024. doi: 10.4239/wjd.v15.i6.1162
Adipose-derived stem cells in diabetic foot care: Bridging clinical trials and practical application
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
Song-Lu Tseng, Department of Plastic and Reconstructive Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Song-Lu Tseng, Zhu-Jun Li, Li-Quan Wang, Zi-Ming Li, Tian-Hao Li, Jie-Yu Xiang, Jiu-Zuo Huang, Nan-Ze Yu, Xiao Long, Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Lin Kang, Biomedical Engineering Facility, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, Beijing 100021, China
Author contributions: Tseng SL was responsible for data organization and manuscript drafting; Kang L undertook the manuscript editing and correction process; Li ZJ, Wang LQ, Li ZM, Li TH and Xiang JY contributed to the revision of figures and tables within the manuscript; Huang JZ, Yu NZ, X and Long X were involved in establishing the conceptual framework and overall structure of the manuscript; All authors have read and approve the final manuscript.
Supported byNational Key R&D Program of China, No. 2020YFE0201600; CAMS Innovation Fund for Medical Sciences, No. 2020-I2M- C&T-A-004; and National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-041, No. 2022-PUMCH-A-210 and No. 2022-PUMCH-C-025.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao Long, MD, PhD, Chief Physician, Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. pumclongxiao@126.com
Received: December 20, 2023 Revised: March 3, 2024 Accepted: April 19, 2024 Published online: June 15, 2024 Processing time: 173 Days and 16.7 Hours
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.
Core Tip: This review critically analyzes the current state of research on the efficacy of adipose-derived stem cells (ADSCs) against diabetic foot ulcers (DFUs). It offers a comprehensive overview of diabetic foot classification, clinical management, and the ADSC therapy intricacies. Despite its potential, the field faces challenges like biased trial designs, ambiguous inclusion criteria and intervention strategies. The review highlights these issues and discusses the preclinical efforts to enhance ADSC efficacy. It emphasizes the necessity of more rigorous research and refinement of therapeutic approaches to improve treatment outcomes in diabetic wound care and guide future research.
