Current status of cell therapy for diabetic foot ulcer

Diabetic foot ulcer (DFU) involves multiple pathological mechanisms, including hyperglycemia, oxidative stress, inflammation, and impaired angiogenesis. Cell therapy has shown significant potential in the treatment of DFU, involving mesenchymal stem cells (MSCs), endothelial progenitor cells (EPCs), induced pluripotent stem cells (iPSCs), and mixed cell populations such as bone marrow mononuclear cells (BM-MNCs), peripheral blood mononuclear cells (PB-MNCs), and adipose derived stromal vascular components (AD-SVF). MSCs promote angiogenesis and tissue repair through paracrine effects; EPCs differentiate into endothelial cells and secrete pro-angiogenic factors to improve blood flow; iPSCs can differentiate into various cell types to facilitate wound healing via genetic reprogramming. Mixed cell populations exhibit remarkable clinical outcomes due to their heterogeneity and synergistic effects. Despite the notable efficacy of these therapies, further investigation is required for standardized preparation, long-term safety, and optimal treatment protocols. Future research should focus on optimizing combinations of cell therapies and integrating them with other treatments to enhance their widespread clinical application.