Stem Cells In Diabetic Wound Healing
Diabetes is a serious debilitating disease and it is on the rise. In 1980 an estimated 108 million people were living with diabetes and the number ballooned four-fold in just 35 years to over 422 million diabetes patients in 2014 (World Health Organisation, 2017). The number of diabetes patients may be more than 360 million in 2030. In 2015 alone, it was the direct cause of death of 1.5 million patients . Diabetes is also one of the major culprits that lead to other complications such as cardiac ischemia, cerebral ischemia, renal failure, amputation and neuropathy. Among these complications, lower extremity amputation caused by diabetic ulcers is 20 times higher in diabetic patients as compared to non-diabetic patients this translates to a higher wound management cost as well; this has become a major global health burden. For example, in the United Kingdom alone, its National Health Service report shows that annually up to 5 billion pounds were spent for diabetic wound treatment.
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Mesenchymal stem cells (MSCs) transplantation seems to be a promising new therapy for diabetic wound healing (DWH) and currently, arrays of MSCs from various sources ranging from umbilical, adipose to dental sources are available as a treatment modality for this disease. However, it now appears that only a fraction of transplanted cells actually assimilate and survive in host tissues suggesting that the major mechanism by which stem cells participate in tissue repair are most likely related to their secretome level. These include a wide range of growth factors, cytokines and chemokines, which can be found from the conditioned medium used to culture the cells. Basic studies and preclinical work confirm that the therapeutic effect of conditioned media (CM) is comparable to the application of stem cells.
