Mesenchymal Stem Cells Improve Healing of Diabetic Foot Ulcer

Figure 1

Mechanism of BM-MSCs for treatment of DFU. BM-MSCs can migrate and adhere via CCR7, ICAM1-, VCAM1-, and Akt- dependent mechanism and enhance angiogenesis through increasing VEGF, NGF, BDNF, VEGF-A, eNOS, and HIF. Cell proliferation of HUVECs and keratinocytes plays significant role in angiogenesis and reepithelialization, respectively. Keratinocyte function is improved by regulating IGF-1, EGF, MMP-2, MMP-9, TIMP-1, TIMP-2, and Erk signaling pathway. CCR7: C-C chemokine receptor type 7, ICAM1: intercellular adhesion molecule 1, VCAM1: vascular adhesion molecule 1, VEGF: vascular endothelial growth factor, NGF: nerve growth factor, BDNF: brain-derived neurotrophic factor, VEGF-A: vascular endothelial growth factor A, eNOS: endothelial nitric oxide synthase, HIF: hypoxia inducible factor, IGF-1: insulin-like growth factor 1, EGF: epidermal growth factor, MMP-2: matrix metalloproteinase-2, MMP-9: matrix metalloproteinase-9, TIMP-1: tissue inhibitor of metalloproteinase-1, and TIMP-2: tissue inhibitor of metalloproteinase-2.