间充质干细胞外泌体对于糖尿病足溃疡的治疗策略

Therapeutic Strategies of Mesenchymal Stem Cell Exosomes for Diabetic Foot Ulcer

摘要: 糖尿病足溃疡(DFU)是糖尿病患者神经病变和不同程度的外周血管病变的组合，导致下肢感染、溃疡形成和深部组织坏死。糖尿病患者伤口愈合困难是由患者的高葡萄糖环境和各种生物因素引起的。患者的皮肤局部微环境改变和免疫趋化反应功能障碍。伤口容易反复损伤和溃疡，但难以愈合，最终发展为慢性溃疡。DFU是一个复杂的生物过程，其中许多细胞相互作用。从伤口释放的各种生长因子对于协调和促进愈合是必要的。间充质干细胞(MSCs)是再生治疗的理想细胞来源，在糖尿病足溃疡(DFU)中起着重要作用。外泌体是MSCs的关键分泌产物之一，类似于亲代MSCs的作用。它们可以穿梭各种蛋白质、信使RNA (mRNA)和microRNAs (miRNAs)，调节受体细胞的活性，并在皮肤伤口愈合中发挥重要作用。与间充质干细胞相比，外泌体更便于储存和运输。此外，它们还避免了与细胞移植相关的许多风险。因此，MSC-外泌体介导的治疗可能更安全有效。本文对糖尿病足溃疡的治疗策略的变化及发展作归纳，并就间充质干细胞外泌体对于糖尿病足溃疡的研究进展及治疗策略进行汇总，探讨其未来对于DFU的治疗策略的影响。

Abstract: Diabetic Foot Ulcer (DFU) is a combination of neuropathy and peripheral vascular diseases of vary-ing degrees in diabetic patients, leading to infection of the lower extremities, ulcer formation and deep tissue necrosis. The difficulty of wound healing in diabetic patients is caused by the patient’s high glucose environment and various biological factors. The patient’s skin’s local microenviron-ment changes and immunochemotactic response dysfunction is impaired. Wounds are prone to re-peated injuries and ulcers, but are difficult to heal and eventually develop chronic ulcers. DFU is a complex biological process in which many cells interact with each other. The release of various growth factors from the wound is necessary to coordinate and promote healing. Mesenchymal stem cells (MSCs) are an ideal source of cells for regenerative therapy and play an important role in dia-betic foot ulcers (DFU). Exosomes are one of the key secretory products of MSCs, similar to the role of parental MSCs. They can shuttle various proteins, messenger RNA (mRNA) and microRNAs (miR-NAs), regulate the activity of recipient cells, and play an important role in skin wound healing. Exo-somes are easier to store and transport than mesenchymal stem cells. In addition, they avoid many of the risks associated with cell transplantation. Therefore, MSC-exosome mediated therapy may be safer and more effective. In this paper, the changes and development of therapeutic strategies for diabetic foot ulcer are summarized, and the research progress and therapeutic strategies of mes-enchymal stem cell exosomes for diabetic foot ulcer are summarized, and their future influence on the therapeutic strategies for DFU is discussed.