Improved wound healing of diabetic foot ulcers using human placenta-derived mesenchymal stem cells in gelatin electrospun nanofibrous scaffolds plus a platelet-rich plasma gel: A randomized clinical trial.

Autor: Meamar R; Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: meamar@pharm.mui.ac.ir., Ghasemi-Mobarakeh L; Department of Textile Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran., Norouzi MR; Department of Textile Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran., Siavash M; Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran., Hamblin MR; Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa., Fesharaki M; Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Jazyk: angličtina
Zdroj: International immunopharmacology [Int Immunopharmacol] 2021 Dec; Vol. 101 (Pt B), pp. 108282. Date of Electronic Publication: 2021 Oct 28.
DOI: 10.1016/j.intimp.2021.108282
Abstrakt: Aim: The effectiveness of nanofibers containing human placenta-derived mesenchymal stem cells (hPDMSCs) plus platelet-rich plasma (PRP) for healing of diabetic foot ulcers (DFUs) was investigated.
Methods: hPDMSCs were isolated from human donor placentas, and cultured in electrospun gelatin nanofibrous scaffolds (GNS). Twenty-eight patients with DFUs were randomized into three groups in a 12-week trial: (A) Treated with hPDMSCs; (B) Treated with hPDMSCs after coating the ulcer with PRP gel; (C) Control group received standard wound care. Wound area and pain freewalkingdistance were measured every 2 weeks.
Results: Flow cytometry showed the expression of mesenchymal markers. SEM images and DAPI staining indicated significantly higher levels of hPDMSC proliferation on GNS after 3 and 7 days of culture. The MTS assay showed a significant increase in proliferation on GNS, compared to controls. Wound size reduction was 66% in group A, 71% in group B, and 36% in control group C. A significant difference in wound closure and pain-free walking distance was observed between groups A and B, compared to control group C (p < 0.05), but no difference between groups A and B. Biopsy of the implanted tissue showed the development of new capillary formation in groups A and B.
Conclusion: Implantation of hPDMSCs in GNS accelerated wound healing and improved clinical parameters in DFU patients.
(Copyright © 2021. Published by Elsevier B.V.)
Databáze: MEDLINE
Externí odkaz: