فهرست نشریات علمی دسترسی آزاد ایران

Diabetic foot ulcer (DFU) is a prevalent and severe complication of diabetes mellitus (DM), posing significant economic and psychological challenges for patients. This study aimed to evaluate the therapeutic efficacy of umbilical cord-derived mesenchymal stem cells (UC-MSCs) for DFU by conducting a systematic review and meta-analysis of clinical outcomes, including ulcer healing, ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO₂), and Hemoglobin A1c (HbA1c) levels. A comprehensive systematic search was performed across the Cochrane, PubMed, and Scopus databases to identify relevant studies suitable for meta-analysis. Key outcomes assessed included ABI, ulcer healing, TcPO₂, and HbA1c. Dichotomous data were reported as odds ratios (OR) with corresponding 95% confidence intervals (CIs), whereas continuous outcomes were evaluated as standard mean difference (SMD) with 95% CIs. Statistical analyses were conducted using R (version 4.3.2).The meta-analysis included four studies comprising 115 participants (59 cases and 56 controls). UC-MSC therapy demonstrated superior efficacy compared to controls, with significant improvements in complete ulcer closure rates [OR = 48.97 (1.38, 1736.47)], ABI [SMD = 1.34 (0.78, 1.90)], and TcPO₂ [SMD = 1.90 (-0.38, 4.18)], along with a marked reduction in HbA1c levels [SMD = -2.63 (-4.80, -0.45)]. However, the wide confidence intervals for some outcomes (e.g., OR = 48.97 [1.38, 1736.47]) suggest uncertainty and highlight the need for cautious interpretation of these findings. UC-MSC therapy shows promise as a treatment for DFU, with potential benefits in ulcer healing, ABI, TcPO₂, and HbA1c reduction. However, the small number of studies and wide confidence intervals underscore the need for larger, more robust, multi-center, randomized, double-blind, placebo-controlled trials with extended follow-up periods to confirm these findings and optimize UC-MSC therapeutic strategies for DFU.