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Effectiveness of preconditioned adipose-derived mesenchymal stem cells with photobiomodulation for the treatment of diabetic foot ulcers: a systematic review

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Abstract

The primary goal of this systematic review article was to provide an outline of the use of diabetic autologous adipose-derived mesenchymal stem cells (DAAD-MSCs) in the treatment of wounds and ulcers in animal models and patients with diabetes mellitus (DM). The secondary goal was to present the outcomes of pretreatment of diabetic adipose-derived mesenchymal stem cells (DAD-MSCs) with probable different agents in the treatment of diabetic foot ulcers (DFUs) and wounds. In view of possible clinical applications of AD-MSC-mediated cell therapy for DFUs, it is essential to evaluate the influence of DM on AD-MSC functions. Nevertheless, there are conflicting results about the effects of DAAD-MSCs on accelerating wound healing in animals and DM patients. Multistep research of the MEDLINE, PubMed, Embase, Clinicaltrials.gov, Scopus database, and Cochrane databases was conducted for abstracts and full-text scientific papers published between 2000 and 2020. Finally, 5 articles confirmed that the usage of allogeneic or autologous AD-MSCs had encouraging outcomes on diabetic wound healing. One study reported that DM changes AD-MSC function and therapeutic potential, and one article recommended that the pretreatment of diabetic allogeneic adipose-derived mesenchymal stem cells (DAlD-MSCs) was more effective in accelerating diabetic wound healing. Recently, much work has concentrated on evolving innovative healing tactics for hastening the repair of DFUs. While DM alters the intrinsic properties of AD-MSCs and impairs their function, one animal study showed that the pretreatment of DAlD-MSCs in vitro significantly increased the function of DAlD-MSCs compared with DAlD-MSCs without any treatment. Preconditioning diabetic AD-MSCs with pretreatment agents like photobiomodulation (PBM) significantly hastened healing in delayed-healing wounds. It is suggested that further animal and human studies be conducted in order to provide more documentation. Hopefully, these outcomes will help the use of DAAD-MSCs plus PBM as a routine treatment protocol for healing severe DFUs in DM patients.

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Data availability

Since our work was a systematic review article without any statistical analysis requirement, we added a full text of the final approved articles which were evaluated in this work.

Abbreviations

DM:

Diabetes mellitus

DFU:

Diabetic foot ulcer

MSC:

Mesenchymal stem cell

AAD-MSC:

Autologous adipose-derived mesenchymal stem cells

AD-MSC:

Adipose-derived mesenchymal stem cells

DAAD-MSC:

Diabetic autologous adipose-derived mesenchymal stem cells

VEGF:

Vascular endothelial growth factor

TGF-β:

Transforming growth factor-beta

Ga-Al-As:

Gallium-aluminum-arsenide laser

h:

Human

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

STZ:

Streptozotocin

DM1:

Type 1 diabetic

scCO2 :

Supercritical carbon dioxide

ADM:

Acellular dermal matrix

CLI:

Critical limb ischemia

PBM:

Photobiomodulation

DAlD-MSCs:

Diabetic allogeneic adipose-derived stem cell

i.p.:

Intraperitoneal

CD:

Cluster of differentiation

MTT:

3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay

PDT:

Population doubling time

DM2:

Type 2 DM

TLRs:

Toll-like receptors

IL-1R1:

IL-1 receptors, type 1

bFGF:

Basic fibroblast growth factor

LLLT:

Low-level laser therapy

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Authors and Affiliations

  1. Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Abdollah Amini & Mohammad Bayat

  2. Price Institute of Surgical Research, University of Louisville, University of Louisville, and Noveratech LLC, Louisville, KY, USA

    Sufan Chien & Mohammad Bayat

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  1. Abdollah Amini
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  2. Sufan Chien
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AA, MB, and SC gathered data, AA wrote the first draft, MB and SC edited it, and MB submitted it to the journal.

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Correspondence to Sufan Chien or Mohammad Bayat.

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Amini, A., Chien, S. & Bayat, M. Effectiveness of preconditioned adipose-derived mesenchymal stem cells with photobiomodulation for the treatment of diabetic foot ulcers: a systematic review. Lasers Med Sci 37, 1415–1425 (2022). https://doi.org/10.1007/s10103-021-03451-6

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