The following article requires a subscription:



(Format: HTML, PDF)

Aim: The effectiveness of nanofibers containing human placenta-derived mesenchymal stem cells (hPDMSCs) plus platelet-rich plasma (PRP) for healing of diabetic foot ulcers (DFUs) was investigated.

Methods: hPDMSCs were isolated from human donor placentas, and cultured in electrospun gelatin nanofibrous scaffolds (GNS). Twenty-eight patients with DFUs were randomized into three groups in a 12-week trial: (A) Treated with hPDMSCs; (B) Treated with hPDMSCs after coating the ulcer with PRP gel; (C) Control group received standard wound care. Wound area and pain free walking distance were measured every 2 weeks.

Results: Flow cytometry showed the expression of mesenchymal markers. SEM images and DAPI staining indicated significantly higher levels of hPDMSC proliferation on GNS after 3 and 7 days of culture. The MTS assay showed a significant increase in proliferation on GNS, compared to controls. Wound size reduction was 66% in group A, 71% in group B, and 36% in control group C. A significant difference in wound closure and pain-free walking distance was observed between groups A and B, compared to control group C (p < 0.05), but no difference between groups A and B. Biopsy of the implanted tissue showed the development of new capillary formation in groups A and B.

Conclusion: Implantation of hPDMSCs in GNS accelerated wound healing and improved clinical parameters in DFU patients.

Highlights:

* Gelatin nanofibers used as a scaffold for hPDMSCs delivery to the wound area.

* A higher rate of wound repair was in the group treated with hPDMSCs - gelatin nanofibers.

* An increasing of vascularization was in the group treated with hPDMSCs - gelatin nanofibers.

(C) 2021Elsevier, Inc.