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Allogenic Adipose-Derived Stem Cells for DFUs: What is the Latest Evidence?

David G. Armstrong, DPM, MD, PhD

Intriguing work recently emerged from our friend and colleague Professor Beata Rakowska and coworkers from Poland. A recent study in the International Journal of Molecular Science took a closer look at the safety and efficacy of allogenic adipose-derived stem cells (ADSCs) in diabetic foot ulcer (DFU) treatment.1 The authors pointed out that results thus far with respect to wound healing are encouraging, but that in vitro and animal studies comprise the majority of the evidence available on the mechanism of action. Researchers formed two cohorts of 23 patients who received fibrin gel with or without ADSCs. They then assessed results at day 7, 14, 21, and 49. During these assessments, the researchers collected samples from debridement to analyze for ADSC donor DNA and proteomic changes.1
 
The cohort receiving ADSCs had greater reduction in wound size at all visits and significantly shorter time to 50% reduction in wound size than those who did not receive ADSCs.1 Researchers identified 34 proteins significantly differentiated the material in both groups, and 7 positively correlated with wound healing. ADSC donor DNA was detectable up to 21 days after application.1
 
The authors say that this confirms ADSC-related improvement in wound healing that is correlatable with the molecular background, and might represent a step forward in developing more cell-based therapies.1
 
We and our greater team have had a good deal of experience with adipose-derived cells for both wound healing and for reducing risk for recurrence in diabetic foot remission. We think these data support some of our previous efforts and look forward to more advancements in this area. For more on this, check out a recently published study on 3D printing adipose “biodressings” here.

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA).

Editor’s note: This blog originally appeared here. It is adapted with permission from the author.

Reference
1.     Mrozikiewicz-Rakowska B, Szablowska-Gadomska I, Cysewski D, et al. Allogenic adipose-derived stem cells in diabetic foot ulcer treatment: clinical effectiveness, safety, survival in the wound site, and proteomic impact. Int J Mol Sci. 2023;24(2):1472.

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