TY - JOUR
T1 - 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
T2 - A randomized clinical trial
AU - Meamar, Rokhsareh
AU - Ghasemi-Mobarakeh, Laleh
AU - Norouzi, Mohammad Reza
AU - Siavash, Mansour
AU - Hamblin, Michael R.
AU - Fesharaki, Mehrafarin
N1 - Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - 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 free walking distance 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.
AB - 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 free walking distance 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.
KW - Diabetic foot ulcer
KW - Electrospun gelatin nanofiber scaffold
KW - Platelet-rich plasma
KW - Randomized clinical trial
KW - Stem cells
KW - hPDMSCs
UR - http://www.scopus.com/inward/record.url?scp=85117960439&partnerID=8YFLogxK
U2 - 10.1016/j.intimp.2021.108282
DO - 10.1016/j.intimp.2021.108282
M3 - Article
C2 - 34737130
AN - SCOPUS:85117960439
SN - 1567-5769
VL - 101
JO - International Immunopharmacology
JF - International Immunopharmacology
M1 - 108282
ER -