The Pathological Foundation of Stem Cell Therapy for Diabetic Foot

Key words: stem cell therapy, diabetic foot, neovascularization

Diabetic foot, also known as diabetic gangrene, is defined as: diabetic patients with various degrees of peripheral vascular disease and neuropathy manifest lower extremity infections, ulcers and/ or deep tissue destruction.
Vascular disease, neuropathy and trauma are called pathological manifestations triad of diabetes. Diabetic pathological changes are based on a variety of complex molecular biology.

1. Vascular lesions and growth factors reduction. Many factors affect the healing process of diabetic foot ulcers, including growth factors reduction, angiogenesis disorders, macrophage dysfunction, collagen accumulation, keratinocytes and fibroblasts migration and proliferation and metalloprotease metabolic disorders.

2. Some kinds of ulcer local cells are abnormal, such as fibroblasts, macrophages and keratinocytes. Therefore, in order to heal the ulcer, we must remove these abnormal cells completely. Meanwhile, it also should be done that to replenish required cells to promote the ulcer healing.

3. Furthermore, the patients with diabetic foot suffer from the damages to sensory and motor nerve.

Purpose of the treatment of diabetic foot is to minimize the formation of ulcers, reduce the risk of amputation, reduce foot deformity, relieve pain and improve foot appearance. With the rapid development of regenerative medicine, experimental study on the neovascularization has made considerable progress in the treatment of diabetic foot. The effectiveness of stem cell therapy has been confirmed.

Stem cell therapy plays a significant role in the following two aspects: Firstly, stem cell contains endothelial progenitor cells (EPCs), which may participate in ischemic tissue angiogenesis. Stem cell also can provide endothelial cells for the neovascularization of ischemic tissue and could through paracrine attack surrounding mature endothelial cell proliferation and migration. Secondly, the stem cells produce a variety of cytokines and growth factors that can induce angiogenesis.