The Effect of Stem Cell Secretome on the Improvement of Diabetic Wound Recovery: A Systematic Review and Meta-Analysis of In Vivo Studies

IF 1.6 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Current Therapeutic Research-clinical and Experimental Pub Date : 2025-01-01 DOI:10.1016/j.curtheres.2025.100778

Cecep Suhandi MSc , Gofarana Wilar PhD , Khaled M. Elamin PhD , Audry Rahma Dewayani BSc , Salsabil Ghaliya BSc , Astriani Abdullah BSc , Nasrul Wathoni PhD

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引用次数: 0

Abstract

Background

Diabetic wounds, characterized by their chronic nature, represent a critical challenge for patients with diabetes, often leading to amputation and mortality. Although stem cells show great promise, their use is limited by challenges related to stability and tumorigenicity. The secretome of stem cells, comprising molecules released by these cells, offers a potential alternative to the challenges associated with stem cell therapy and provides a promising solution for diabetic wound healing.

Objective

We conducted a systematic review and meta-analysis of relevant preclinical studies to evaluate the effectiveness of stem cell secretomes in treating diabetic wounds.

Methods

The protocol registration for this systematic review and meta-analysis was recorded in the PROSPERO database (CRD42023473726). Databases were searched from their inception until November 20, 2023. The quality assessment of the included studies was performed utilizing the CAMARADES 10-item Quality Checklist. Statistical analyses were conducted using a random-effects model to calculate standardized mean differences (SMD) and 95% confidence intervals (CI), with heterogeneity assessed via the I² statistic. The primary outcome evaluated was the wound closure rate, while secondary outcomes included parameters such as the number of fibroblasts, neutrophils, and macrophages.

Results

Twenty studies were included, comprising 382 animal subjects, and five of which were eligible for quantitative evaluation in a meta-analysis. The stem cell secretome significantly improved the wound closure rate (SMD = 9.63; 95% CI = 2.01 −17.25; P = 0.01, I² = 76%) and reduced the number of neutrophils (SMD = −8.47; 95% CI = −13.05 to −3.90; P = 0.0003) and macrophages (SMD = −5.32; 95% CI = −9.09 to −1.55; P = 0.006).

Conclusion

This review suggests that stem cell secretomes have potential as a novel therapeutic strategy for diabetic wound healing, enhancing wound closure rates and reducing inflammation. These findings support the use of stem cell secretomes as a safer and more stable alternative to direct stem cell therapy, but further clinical studies are needed to confirm these results in human patients.

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干细胞分泌组对改善糖尿病伤口恢复的作用：体内研究的系统回顾和荟萃分析

糖尿病伤口以其慢性性质为特征，对糖尿病患者来说是一个严峻的挑战，经常导致截肢和死亡。尽管干细胞显示出巨大的前景，但其应用受到稳定性和致瘤性方面的挑战的限制。干细胞分泌组由这些细胞释放的分子组成，为干细胞治疗相关的挑战提供了一个潜在的替代方案，并为糖尿病伤口愈合提供了一个有希望的解决方案。目的对相关临床前研究进行系统回顾和荟萃分析，评价干细胞分泌组治疗糖尿病创面的有效性。方法本系统评价和荟萃分析的方案注册记录在PROSPERO数据库（CRD42023473726）中。数据库从建立到2023年11月20日被搜索。采用CAMARADES 10项质量检查表对纳入的研究进行质量评估。采用随机效应模型进行统计分析，计算标准化平均差异（SMD）和95%置信区间（CI），并通过I²统计量评估异质性。评估的主要结局是伤口愈合率，次要结局包括成纤维细胞、中性粒细胞和巨噬细胞数量等参数。结果纳入20项研究，包括382名动物受试者，其中5项符合meta分析的定量评价标准。干细胞分泌组显著提高创面愈合率(SMD = 9.63；95% ci = 2.01−17.25；P = 0.01, I2 = 76%)，中性粒细胞数量减少(SMD =−8.47；95% CI =−13.05 ~−3.90；P = 0.0003)和巨噬细胞(SMD =−5.32；95% CI =−9.09 ~−1.55；p = 0.006)。结论干细胞分泌组有潜力作为糖尿病创面愈合的新治疗策略，提高创面愈合率，减少炎症。这些发现支持使用干细胞分泌组作为直接干细胞治疗的更安全、更稳定的替代方法，但需要进一步的临床研究来证实这些结果在人类患者中的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Therapeutic Research-clinical and Experimental 医学-药学

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

3 months

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