糖尿病足溃疡的细胞治疗现状  

Current status of cell therapy for diabetic foot ulcer

作　　者：支黎明 王晶 王爱萍 ZHI Liming;WANG Jing;WANG Aiping(Diabetic Foot Center,Air Force Hospital of Eastern Theater Command of PLA,Nanjing,Jiangsu 210016,China)

机构地区：[1]东部战区空军医院糖尿病足中心,江苏南京210016

出　　处：《中国临床研究》2025年第4期497-501,共5页Chinese Journal of Clinical Research

摘　　要：糖尿病足溃疡涉及高血糖、氧化应激、炎症及血管生成受损等多种病理机制。细胞治疗在糖尿病足溃疡中展现显著潜力,包括间充质干细胞(MSCs)、内皮祖细胞(EPCs)、诱导多能干细胞(iPSCs)及混合细胞群[如骨髓单个核细胞(BM-MNCs),外周血单个核细胞(PB-MNCs)和脂肪来源基质血管成分(AD-SVF)]。MSCs通过旁分泌促进血管生成和组织修复;EPCs分化为内皮细胞并分泌促血管生成因子改善血流;iPSCs经基因重编程可分化为多种细胞类型促进愈合。混合细胞群因其异质性和协同效应在临床治疗中表现出色。尽管这些疗法疗效显著,其标准化制备、长期安全性和最佳方案仍需深入研究。未来应优化细胞疗法组合及其与其他治疗方法的联合应用以推动临床广泛应用。Diabetic foot ulcer(DFU)involves multiple pathological mechanisms,including hyperglycemia,oxidative stress,inflammation,and impaired angiogenesis.Cell therapy has shown significant potential in the treatment of DFU,involving mesenchymal stem cells(MSCs),endothelial progenitor cells(EPCs),induced pluripotent stem cells(iPSCs),and mixed cell populations such as bone marrow mononuclear cells(BM-MNCs),peripheral blood mononuclear cells(PB-MNCs),and adiposederived stromal vascular components(AD-SVF).MSCspromote angiogenesis and tissue repair through paracrine effects;EPCs diferentiate into endothelial cells and secrete pro-angiogenic factors to improve blood flow;iPSCs can dfferentiate into various cell types to facilitate wound healing via genetic reprogramming.Mixed cell populations exhibit remarkable clinical outcomes due to their heterogeneity and synergistic effects.Despite the notable efficacy of these therapies,further investigation is required for standardized preparation,long-term safety,and optimal treatment protocols.Future research should focus on optimizing combinations of cell therapies and integrating them with other treatments to enhance their widespread clinical application.

关 键 词：糖尿病足溃疡 细胞治疗 间充质干细胞 内皮祖细胞 诱导多能干细胞 混合细胞群 创面愈合 

分 类 号：R587.2[医药卫生—内分泌]