Table 1.

Advantages and limitations of the stem cells enhancing healing in DFUs. Stem cells showed improved clinical efficacy in enhancing wound healing in DFUs by increased angiogenesis and re-epithelialization [17]. The common side effects associated with stem cell therapy are whole body urticaria, diarrhea, oral ulceration, the elevation of serum creatinine level, number, and differentiated potential decline with aging, nausea, and vomiting. Bone marrow-mesenchymal stem cells (BM-MSCs), umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs), adipose-derived mesenchymal stem cells (AMSCs), umbilical cord-derived mesenchymal stem cells (UC-MSCs), placenta-derived mesenchymal stem cells (PMSCs), and human amniotic fluid-derived stem cells (AF-MSCs), human gingiva-derived mesenchymal stem cells (GMSCs).

Source of Stem Cells	Advantages
BM-MSCs	No immunologic restriction, does not stimulate alloreactivity, escape lysis by T-cells and NK cells Reduced formation of cytotoxic lymphocytes suppresses T-cell-derived IFN-γ, intramuscular transplantation
UCB-MSCs	Similar morphology and cell surface antigens, the potential of differentiation into BM-MSCs Short doubling time, long viable time, anti-inflammatory activity, intramuscular transplantation
AMSCs	Characteristics like BM-MSCs, subcutaneous injection
UC-MSCs	Rich, safe, of short doubling time, and easy to collect Fibroblastic morphology, typical immunophenotypic markers, and multiple differentiation potential to BM-MSCs, lower immunogenicity
PMSCs	A large number of cells can be isolated, better proliferation capacity, intraperitoneal administration The morphology, size, surface phenotype, and immunosuppressive characteristics are like BM-MSCs
AF-MSCs	A large number of cells can be isolated from the small volume, remain stable, have a high proliferative capacity, multilineage differentiation potential, immunomodulatory activity Lack of significant immunogenicity
GMSCs	Homogenous, not tumorigenic, easy to isolate, stable phenotype, can be isolated without ethical problems, greater capacity of proliferation and migration than AMSCs and BM-MSCs without growth factors