Cell Therapies: New Frontier for the Management of Diabetic Foot Ulceration

While stem cells hold great potential to improve existing therapies for diabetic foot ulcers (DFUs), their promise has not been fully exploited. There is a critical need to further develop existing sources of adult stem cells and to test novel sources of induced pluripotent stem cells (iPSCs) to improve impaired wound repair when delivered to DFUs. This chapter summarizes the capacity of multiple adult stem cell sources, including bone marrow-derived mesenchymal stem cells, hematopoietic stem cells, endothelial progenitor cells, bone marrow and peripheral blood mononuclear cells, and adipose stem cells, to improve DFU healing outcomes in pre-clinical animal models and human clinical trials. We also review more recently developed technologies, such as iPSC-derived cell sources, CRISPR gene editing, and 3D human skin equivalent tissue models to generate diverse cell types needed for DFU healing and to streamline their pre-clinical testing. By further understanding how stem cells and related new technologies can best stimulate tissue regeneration, we will be able to overcome existing barriers to improve DFU therapies.