Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials
Lower extremity chronic wounds (LECWs) commonly occur in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD). Autologous stem cell therapy (ASCT) has emerged as a promising alternative treatment for those who suffered from LECWs. The purpose of this study was to assess the eff...
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MDPI AG
2021-11-01
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| Online Access: | https://www.mdpi.com/2073-4409/10/12/3307 |
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| author | Kuan-Ju Chiang Li-Cheng Chiu Yi-No Kang Chiehfeng Chen |
| author_facet | Kuan-Ju Chiang Li-Cheng Chiu Yi-No Kang Chiehfeng Chen |
| author_sort | Kuan-Ju Chiang |
| collection | DOAJ |
| description | Lower extremity chronic wounds (LECWs) commonly occur in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD). Autologous stem cell therapy (ASCT) has emerged as a promising alternative treatment for those who suffered from LECWs. The purpose of this study was to assess the effects of ASCT on LECWs. Two authors searched three core databases, and independently identified evidence according to predefined criteria. They also individually assessed the quality of the included randomized controlled trials (RCTs), and extracted data on complete healing rate, amputation rate, and outcomes regarding peripheral circulation. The extracted data were pooled using a random-effects model due to clinical heterogeneity among the included RCTs. A subgroup analysis was further performed according to etiology, source of stem cells, follow-up time, and cell markers. A total of 28 RCTs (<i>n</i> = 1096) were eligible for this study. The pooled results showed that patients receiving ASCT had significantly higher complete healing rates (risk ratio (RR) = 1.67, 95% confidence interval (CI) 1.28–2.19) as compared with those without ASCT. In the <i>CD34</i>+ subgroup, ASCT significantly led to a higher complete healing rate (RR = 2.70, 95% CI 1.50–4.86), but there was no significant difference in the <i>CD34</i>− subgroup. ASCT through intramuscular injection can significantly improve wound healing in patients with LECWs caused by either DM or critical limb ischemia. Lastly, <i>CD34</i>+ is an important cell marker for potential wound healing. However, more extensive scale and well-designed studies are necessary to explore the details of ASCT and chronic wound healing. |
| first_indexed | 2024-03-10T04:25:55Z |
| format | Article |
| id | doaj.art-8c5f4c9f3da44be788ec8fcb4a9db56f |
| institution | Directory Open Access Journal |
| issn | 2073-4409 |
| language | English |
| last_indexed | 2024-03-10T04:25:55Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cells |
| spelling | doaj.art-8c5f4c9f3da44be788ec8fcb4a9db56f2023-11-23T07:35:59ZengMDPI AGCells2073-44092021-11-011012330710.3390/cells10123307Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled TrialsKuan-Ju Chiang0Li-Cheng Chiu1Yi-No Kang2Chiehfeng Chen3School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, TaiwanSchool of Medicine, College of Medicine, Taipei Medical University, Taipei 110, TaiwanDepartment of Health Care Management, College of Health Technology, National Taipei University of Nursing Health Sciences, Taipei 112, TaiwanEvidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, TaiwanLower extremity chronic wounds (LECWs) commonly occur in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD). Autologous stem cell therapy (ASCT) has emerged as a promising alternative treatment for those who suffered from LECWs. The purpose of this study was to assess the effects of ASCT on LECWs. Two authors searched three core databases, and independently identified evidence according to predefined criteria. They also individually assessed the quality of the included randomized controlled trials (RCTs), and extracted data on complete healing rate, amputation rate, and outcomes regarding peripheral circulation. The extracted data were pooled using a random-effects model due to clinical heterogeneity among the included RCTs. A subgroup analysis was further performed according to etiology, source of stem cells, follow-up time, and cell markers. A total of 28 RCTs (<i>n</i> = 1096) were eligible for this study. The pooled results showed that patients receiving ASCT had significantly higher complete healing rates (risk ratio (RR) = 1.67, 95% confidence interval (CI) 1.28–2.19) as compared with those without ASCT. In the <i>CD34</i>+ subgroup, ASCT significantly led to a higher complete healing rate (RR = 2.70, 95% CI 1.50–4.86), but there was no significant difference in the <i>CD34</i>− subgroup. ASCT through intramuscular injection can significantly improve wound healing in patients with LECWs caused by either DM or critical limb ischemia. Lastly, <i>CD34</i>+ is an important cell marker for potential wound healing. However, more extensive scale and well-designed studies are necessary to explore the details of ASCT and chronic wound healing.https://www.mdpi.com/2073-4409/10/12/3307stem cellchronic woundslower limblower extremitydiabetes mellitus footcritical limb ischemia |
| spellingShingle | Kuan-Ju Chiang Li-Cheng Chiu Yi-No Kang Chiehfeng Chen Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials Cells stem cell chronic wounds lower limb lower extremity diabetes mellitus foot critical limb ischemia |
| title | Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials |
| title_full | Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials |
| title_short | Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials |
| title_sort | autologous stem cell therapy for chronic lower extremity wounds a meta analysis of randomized controlled trials |
| topic | stem cell chronic wounds lower limb lower extremity diabetes mellitus foot critical limb ischemia |
| url | https://www.mdpi.com/2073-4409/10/12/3307 |
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