糖尿病伤口愈合的未来：揭示间充质干细胞和外泌体治疗的潜力

The Future of Diabetic Wound Healing: Revealing the Potential of Mesenchymal Stem Cells and Exosome Therapy

摘要: 糖尿病(DM)是一个重大的公共卫生问题，是世界范围内最具挑战性的医疗条件之一。严重的并发症使DM更加复杂。糖尿病性伤口就是其中一种并发症。糖尿病患者患糖尿病足溃疡(DFU)的风险较高。由于常规治疗的无效，截肢的增长、发病率和死亡率已经被认识到。间充质干细胞(MSCs)能显著促进伤口愈合，但是，干细胞治疗也存在一些风险。外泌体治疗是糖尿病伤口的一种新的治疗选择，已显示出良好的效果。然而，一种更先进的形式——使用外泌体的无细胞疗法已经出现。这种升级版的干细胞疗法提供了更好的疗效，并消除了癌症进展的风险。外泌体疗法从多个角度促进伤口愈合，不像传统方法主要依靠身体的自我修复能力，只提供伤口保护。因此，外泌体疗法有可能有效地取代传统疗法。然而，需要进一步的研究来区分治疗的最佳干细胞类型，确保其安全性，建立适当的剂量，并确定最佳的管理路径。本研究的重点是目前关于糖尿病创面溃疡的文献，其治疗方法，以及间充质干细胞和外泌体治疗DFU的潜力。

Abstract: Diabetes mellitus (DM) is a major public health problem and one of the most challenging medical conditions worldwide. DM is further complicated by serious complications. Diabetic wounds are one such complication. People with diabetes are at higher risk for diabetic foot ulcers (DFU). The increase in amputations, morbidity, and mortality due to the ineffectiveness of conventional treatment has been recognized. Mesenchymal stem cells (MSCs) can significantly promote wound healing, however, there are some risks associated with stem cell therapy. Exosome therapy is a new treatment option for diabetic wounds and has shown good results. However, a more advanced form of cell-free therapy using exosomes has emerged. This upgraded version of stem cell therapy offers better efficacy and eliminates the risk of cancer progression. Exosome therapy promotes wound healing from multiple angles, unlike traditional methods that rely primarily on the body’s ability to repair itself and only provide wound protection. Therefore, exosome therapy has the potential to effectively replace traditional therapies. However, further research is needed to distinguish the optimal stem cell type for treatment, ensure its safety, establish appropriate dosages, and determine the best path of administration. This study focused on the current literature on diabetic wound ulcers, their therapeutic approaches, and the potential of mesenchymal stem cells and exosomes to treat DFU.