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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Stem Cells. May 26, 2026; 18(5): 116280
Published online May 26, 2026. doi: 10.4252/wjsc.v18.i5.116280
Erythropoietin-overexpressing mesenchymal stem cells accelerate diabetic wound healing via steroid signaling pathway modulation
Bao-Dong Ma, Shu-Juan Zhang, Yi-Ming Shao, Ran-Ran Jin, Lei Sun, Peng-Ju Lv, Han Yue, Shou-Kui Hu, Xi-Wen Ma
Bao-Dong Ma, Yi-Ming Shao, Ran-Ran Jin, Lei Sun, Peng-Ju Lv, Han Yue, Cell Research and Translational Center, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, Henan Province, China
Shu-Juan Zhang, Shou-Kui Hu, Department of Laboratory Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, Henan Province, China
Xi-Wen Ma, Department of Geriatric, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, Henan Province, China
Author contributions: Ma BD and Zhang SJ contributed to the study design, data analysis, and manuscript writing, they contributed equally to this manuscript and are co-first authors; Ma BD and Shao YM were responsible for funding acquisition; Shao YM performed data analysis and bioinformatics analysis; Jin RR and Sun L conducted cell experiments; Lv PJ carried out animal experiments; Yue H, Hu SK, and Ma XW were involved in project design, data interpretation, and manuscript review.
Supported by the Science and Technology Project of Henan Province, No. 242102310112 and No. LHGJ20230786; and the Incubation Project of Advanced Medical Research Center, No. XJYXZX2021007.
Institutional review board statement: The study protocol for the collection and use of human umbilical cord-derived mesenchymal stem cells was reviewed and approved by the Ethics Committee of Zhengzhou Central Hospital Affiliated to Zhengzhou University (approval No. 2024-004). Written informed consent was obtained from all tissue donors or their legal guardians prior to sample collection, in accordance with the Declaration of Helsinki.
Institutional animal care and use committee statement: All animal procedures were reviewed and approved by the Institutional Animal Care and Use Committee of Zhengzhou Central Hospital Affiliated to Zhengzhou University, No. ZZU-LAC0241220[023]. All experiments were conducted in accordance with institutional guidelines and the National Institutes of Health Guide for the Care and Use of Laboratory Animals, and all efforts were made to minimize animal suffering and reduce the number of animals used.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: The original contributions presented in the study are included in the article (Supplementary material). Further inquiries can be directed to the corresponding author.
Corresponding author: Xi-Wen Ma, MD, Professor, Department of Geriatric, Zhengzhou Central Hospital Affiliated to Zhengzhou University, No. 16 Tongbai North Road, Zhongyuan District, Zhengzhou 450007, Henan Province, China. maxiwen@zzu.edu.cn
Received: November 7, 2025
Revised: December 1, 2025
Accepted: February 24, 2026
Published online: May 26, 2026
Processing time: 199 Days and 21.5 Hours
Core Tip

Core Tip: This study shows that erythropoietin-overexpressing mesenchymal stem cells (EPO-MSCs) accelerate diabetic wound repair by enhancing fibroblast migration, angiogenesis, and macrophage polarization. Integrated transcriptomic, proteomic, and single-cell analyses identify serum amyloid A3-positive reparative macrophages and C-C motif chemokine ligand-centered macrophage-neutrophil crosstalk as key immune nodes modulated by EPO-MSCs, alongside changes in steroid-related pathways. These mechanistic insights suggest that gene-engineered mesenchymal stem cells can overcome the chronic inflammatory microenvironment of diabetic wounds and provide a rationale for future dose optimization, safety evaluation, and early-phase clinical trials of EPO-MSCs therapy.

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