Systematic Review of Stem Cell-based Treatments for Diabetic Foot Ulcer: Look for the Perfect Cell Therapy

Background: Diabetic foot ulcer (DFU) is one of common and serious diabetes mellitus complications that affects approximately 6% of patients with diabetes1. Besides causing pain and amputation, DFU also imposes substantial economic burden on the healthcare system. Various clinical trials and meta-analysis confirmed that cell-based therapy is capable of enhancing current DFU treatment 2,3. Our objective was to perform systematic review of the research examining the effectiveness of various stem cells (SCs) types administered by different ways in order to improve DFU healing. Methods: In total, we identified 458 relevant publications in PubMed and 438 were excluded after review of content for not meeting the inclusion criteria. Efficiency of different types of stem cells were compared according to the re-epithelialization rate calculation. Results: Overall, our findings indicate that BM-MSCs can be considered as the most effective stem cell type for the treatment of DFU (p<0,05) in comparison with BM-MNCs, adipose tissue-derived stem cells (ADSCs), and peripheral blood CD34+ cells. However, BM-MSCs differ in their efficiency. Topical way of stem cells administration significantly increases the effectiveness of stem cell therapy in humans (p