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Mesenchymal Stromal Cell-Derived Extracellular Vesicles in the Treatment of Diabetic Foot Ulcers: Application and Challenges

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Abstract

Diabetic foot ischemia and ulcer (DFU) persists as a serious diabetes mellitus complication in spite of increased understanding of the pathophysiology and the cellular and molecular responses. Contributing to this pessimistic situation is the lack of effective treatments that are slow to heal the deep chronic wounds and microvascular obstruction. Mesenchymal stromal cells (MSCs) have been tested as a promising cell-based therapy for diabetes in vitro and in vivo, which is able to accelerate wound closure with increased epithelialization, granulation tissue formation and angiogenesis by differentiation into skin cells and paracrine pathways to repair injured cells. The secretomes of MSCs, including cytokines, growth factors, chemokines, and extracellular vesicles containing mRNA, proteins and microRNAs, have immunomodulatory and regenerative effects. This review will shed new light on the therapeutic potential of MSC-derived extracellular vesicles (MSC-EVs) for the treatment of diabetes-induced lower limb ischemia and ulcers. The identification of underlying mechanisms for MSC-EVs regulation on impaired diabetic wound healing might provide a new direction for MSC-centered treatment for diabetic lower limb ischemia and ulcers.

Immunomodulatory and angiogenic effects of MSC-derived extracellular vesicles on diabetic foot ulcer.

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Funding

This study was supported by grants from Health Science and Medical technology of Zhejiang Province (2020KY344).

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Authors and Affiliations

  1. Department of hand and foot surgery, Jinhua Hospital of Zhejiang University, Jinhua, People’s Republic of China

    Tao An, Yi Chen, Yingchun Tu & Ping Lin

  2. Department of hand and foot surgery, Jinhua Central Hospital, 365 Renmin East Road, Jinhua, Zhejiang Province, People’s Republic of China

    Tao An, Yi Chen, Yingchun Tu & Ping Lin

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  1. Tao An
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  2. Yi Chen
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  4. Ping Lin
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Contributions

Tao An: Conceptualization, Tables and diagram, Writing- Original draft preparation.

Yi Chen: Syntax checking. Yingchun Tu: Syntax checking.

Ping Lin: Writing- Reviewing and Editing.

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Correspondence to Ping Lin.

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This article belongs to the Topical Collection: Special Issue on Exosomes and Microvesicles: from Stem Cell Biology to Translation in Human Diseases

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An, T., Chen, Y., Tu, Y. et al. Mesenchymal Stromal Cell-Derived Extracellular Vesicles in the Treatment of Diabetic Foot Ulcers: Application and Challenges. Stem Cell Rev and Rep 17, 369–378 (2021). https://doi.org/10.1007/s12015-020-10014-9

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