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Studies prove that mesenchymal stem cells derived from the patient’s own bone marrow injected into long standing diabetic foot ulcers show a 50% reduction in the ulcer.

Dr. Ahmed Albehairy of Mansoura University in Egypt said when patients were locally injected with mesenchymal stem cells, the ulcer significantly reduced. He also said they had regularly followed these patients for around 6-12 weeks after the treatment to find the size of the ulcer considerably shrunk. This reduction in size was despite the fact that the initial size of the ulcer being much larger in the group that was treated with stem cells.

The Results of the Study

The patients were chosen for both stem cell treatment, and the control group was with a mean HbA1C of 8.3, Body Mass Index of approximately 33 Kg/ m2, with the baseline size of ulcer- 4.66 cm2 & 3.72 cm2 respectively.

Reduction of the ulcer seen after six weeks of treatment:

  • In stem cell treated group-49.9%
  • In control group-7.67%

Reduction in ulcer seen after 12 weeks of treatment:

In stem cells treated group - 68.24%, complete healing was also witnessed in one case

In the control group - 5.27%

No visible complications were seen in stem cell treated patients except for the pain of stem cell aspiration.

How was the Stem Cells Injected into the Wound?

Autologous mesenchymal stem cells were aspirated aseptically from 40 ml of the bone marrow of the patient to be treated with stem cells.

After extraction, the stem cells were subcultured and then injected into the ulcers at eight different locations on two separate occasions approximately a week apart. From then on, the patients were carefully followed up for 2-12 weeks until the study ended.

The amount of pure mesenchymal stem cells injected into the wound of every patient per centimeter square was 3.7*105. The correlation was seen with the number of stem cells injected and the size of reduction in ulcer size. The doctors confirmed that they were not specific to the number of stem cells to be used. A study to find the minimum number of stem cells to be injected to promote healing is under process now.

Process of Wound Healing with Stem Cells

The process of healing occurs due to the ability of the stem cells to stimulate angiogenesis (growing new blood vessels) in the wound bed. The increase in blood supply to the wound brings in enough nutrition to the area and also clears up the dead cells efficiently, thereby promoting wound healing. This increase in blood supply also decreases the excess inflammation and also suppresses scarring at the site.

Why is Diabetic Foot Ulcer Alarming?

The wound tissue goes in for ischemia (complete cut-off of blood supply), and nearly 10-15% of the diabetic ulcers are resistant to any treatment. The only possible intervention becomes limb amputation, which is very disabling for the patient.

Future Hope with Stem Cells

Many studies are done using several types of stem cells, both autogenic and autologous mesenchymal cells, to promote healing in diabetic foot ulcers successfully in various parts of the world.

One study at Tufts University done earlier this year showed that autologous stem cells could be reprogrammed to the pluripotent state to cause healing of diabetic foot ulcers. Most studies in progress only show a positive role of stem cells on a diabetic foot ulcer.

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Ref:

http://www.medscape.com/viewarticle/869455