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Article

Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials

by 1,†, 1,†, 2,3,4,5,6,* and 3,5,7,8,*
1
School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
2
Department of Health Care Management, College of Health Technology, National Taipei University of Nursing Health Sciences, Taipei 112, Taiwan
3
Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
4
Research Center of Big Data and Meta-Analysis Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
5
Cochrane Taiwan, Taipei Medical University, Taipei 110, Taiwan
6
Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei 100, Taiwan
7
Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
8
Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
*
Authors to whom correspondence should be addressed.
Equal contribution.
Academic Editor: Alexander V. Ljubimov
Cells 2021, 10(12), 3307; https://doi.org/10.3390/cells10123307 (registering DOI)
Received: 3 November 2021 / Revised: 19 November 2021 / Accepted: 23 November 2021 / Published: 25 November 2021
(This article belongs to the Section Cell and Gene Therapy)
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 (n = 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 CD34+ 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 CD34− subgroup. ASCT through intramuscular injection can significantly improve wound healing in patients with LECWs caused by either DM or critical limb ischemia. Lastly, CD34+ 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. View Full-Text
Keywords: stem cell; chronic wounds; lower limb; lower extremity; diabetes mellitus foot; critical limb ischemia stem cell; chronic wounds; lower limb; lower extremity; diabetes mellitus foot; critical limb ischemia
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MDPI and ACS Style

Chiang, K.-J.; Chiu, L.-C.; Kang, Y.-N.; Chen, C. Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials. Cells 2021, 10, 3307. https://doi.org/10.3390/cells10123307

AMA Style

Chiang K-J, Chiu L-C, Kang Y-N, Chen C. Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials. Cells. 2021; 10(12):3307. https://doi.org/10.3390/cells10123307

Chicago/Turabian Style

Chiang, Kuan-Ju, Li-Cheng Chiu, Yi-No Kang, and Chiehfeng Chen. 2021. "Autologous Stem Cell Therapy for Chronic Lower Extremity Wounds: A Meta-Analysis of Randomized Controlled Trials" Cells 10, no. 12: 3307. https://doi.org/10.3390/cells10123307

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