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©The Author(s) 2024.
World J Diabetes. Jun 15, 2024; 15(6): 1162-1177
Published online Jun 15, 2024. doi: 10.4239/wjd.v15.i6.1162
Published online Jun 15, 2024. doi: 10.4239/wjd.v15.i6.1162
Ref. | Country | Cell type | Condition | Intervention | Cell count | Follow-up | Enrollment | Outcome |
Mrozikiewicz-Rakowska et al[55], 2023 | Poland | Allogeneic | Ulcer | Hydrogel | 2.5 × 106 cells | 49 d | 47 | The time required for a 50% reduction in wound size was 17.6 ± 1.5 d (P = 0.029) |
Lee et al[41], 2012 | Korea | Allogeneic | Ischemia | Intramuscular injection | 5 × 106 cells | 6 months | 15 | 66.7% of patients showed clinical improvement, with enhanced pain relief, increased claudication walking distance, and the development of vascular collateral networks |
Moon et al[33], 2019 | Korea | Allogeneic | Ulcer | Hydrogel | 1 × 106 cells per film | 12 wk | 59 | Wound closure reached 73% by week 8 and increased to 82% by week 12, with a median closure time of 28.5 d |
Yastı et al[80], 2023 | Türkiye | Autologous | Ulcer | 3D-AMHAT | 15-25 mL of fat | 12 wk | 20 | All wounds, except one, were fully epithelialized by the ninth week, with a mean time to complete closure of 32.20 d |
Bajuri et al[81], 2023 | Malaysia | Autologous | Ulcer | 3D-AMHAT | 20 mL of fat | 12 wk | 10 | Within 12 wk, complete healing was observed in 70% of the patients |
Bura et al[31], 2014 | France | Autologous | Ischemia | Intramuscular injection | 1 × 108 cells | 6 months | 7 | All ulcers showed 100% improvement after 6 months, with three completely healed |
Uzun et al[82], 2021 | Türkiye | Allogeneic | Ulcer | Injection | 6 × 106 cells | 4 years | 20 | 90% healing, with no adverse reactions |
Nolan et al[83], 2022 | United Kingdom | Autologous | Ulcer | Intramuscular injection | / | 4 wk | 18 | Increased mean microvessel density by + 32% to + 45% at 1 wk (P = 0.035) |
Dreifuss et al[84], 2017 | United States | Autologous | Pedal atrophy | Injection | / | 12 months | 23 | Dermal thickness increased significantly post-injection, persisting through 24 months (P < 0.05) |
Kress et al[85], 2023 | United States | Autologous | Ulcer | Injection | 13.9 mL of fat | 9.3 months | 10 | Achieved full clinical recovery with no reulceration |
Carstens et al[53], 2021 | United States | Autologous | Ulcer | Subcutaneous injection | 3 × 107 cells | 12 months | 63 | At 6 months, 51 subjects achieved complete closure, and 8 had closure of ≥ 75% |
Nilforoushzadeh et al[86], 2020 | Iran | Autologous | Ulcer | Engineered skin graft | / | 21 wk | 5 | There was a significant increase (P ≤ 0.05) in both skin thickness and vascular bed density |
Lonardi et al[87], 2019 | Italy | Autologous | Minor amputations | Injection | 10-30 mL of fat | 6 months | 114 | At 6 months, 80% of the feet showed healing (P = 0.0064) |
Carstens et al[42], 2017 | United States | Autologous | Ischemia | Intramuscular injection | / | 12 months | 10 | All patients showed clinical improvement (rest pain, claudication, ABI) |
Zollino et al[88], 2019 | Italy | Autologous | Ulcer | Injection | 15 mL of fat | 24 wk | 16 | The average wound healing time was 17.5 ± 7.0 wk (P < 0.036) |
Raposio et al[43], 2018 | Italy | Autologous | Ischemia | Subcutaneous injection | 5 × 105 cells | 6 months | 7 | After 6 months, all patients demonstrated complete wound healing |
Namgoong et al[89], 2010 | Korea | Autologous | Ulcer | Hydrogel | 30-50 mL of fat | 16 wk | 20 | Eight out of 10 patients (80%) achieved complete wound healing after 16 wk, with a reduction in wound area by 4.3 ± 1.0 cm² (P = 0.043) |
Han et al[90], 2010 | Korea | Autologous | Ulcer | Subcutaneous injection | 4.0-8.0 × 106 cells | 8 wk | 54 | 100% healing was achieved |
Smith et al[91], 2020 | United Kingdom | Autologous | Ulcer | Injection | 2 mL of fat/cm² | 21 months | 18 | There was no difference between any of the groups in terms of clinical outcomes |
Gennai et al[92], 2021 | Italy | Autologous | Minor amputations | Injection | 10-30 mL of fat | 6 months | 114 | The average hospital length of stay was 16.2 d (P = 0.025) |
Method | Advantages | Disadvantages |
Intravenous infusion | Targets multiple areas | Cells may get trapped in the lungs |
Arterial injection | Direct delivery to the foot | Technically challenging and risk of blood vessel issues |
Muscular injection | Directly reaches wound, good for poor blood flow, improves cell survival and nerve regeneration | Less effective for wounds away from muscle |
Local injection | High cell concentration at the wound | Risk of uneven cell spread and clumping |
- Citation: Tseng SL, Kang L, Li ZJ, Wang LQ, Li ZM, Li TH, Xiang JY, Huang JZ, Yu NZ, Long X. Adipose-derived stem cells in diabetic foot care: Bridging clinical trials and practical application. World J Diabetes 2024; 15(6): 1162-1177
- URL: https://www.wjgnet.com/1948-9358/full/v15/i6/1162.htm
- DOI: https://dx.doi.org/10.4239/wjd.v15.i6.1162