Shoeblackplant extract-loaded carboxymethyl cellulose/collagen scaffolds seeded with adipose-derived stem cells enhance diabetic wound healing via immunomodulation and angiogenic pathways.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Diabetic wounds are a chronic condition where the typical cascade of wound healing is compromised due to unresolved inflammation, oxidative stress, and dysfunctional angiogenesis. Bioactive dressings with combined stem cell and plant extract-based formulations can provide a multifactorial therapeutic approach for diabetic wounds. The study was aimed at evaluating the wound healing potential of shoeblackplant extract-loaded carboxymethyl cellulose/collagen (CMCCOL) scaffolds seeded with adipose-derived stem cells in vitro and in vivo. Methods Porous CMCCOL scaffolds loaded with shoeblackplant extract (5 %, 7.5 %, and 10 % v/v) were developed by the freeze-drying method and crosslinked using EDC/NHS. Rat adipose-derived stem cells were seeded on the scaffolds for seven days to fabricate ASCs-seeded CMCCOL scaffolds. The cytocompatibility, MTT assay, bacterial penetration test, anti-inflammatory assay (ELISA), Transwell® migration assay, mechanical tensile strength, biodegradation, and drug release profile was evaluated in vitro. The in vivo wound healing study was performed using a full-thickness wound on diabetic rats and treated with ASC-seeded scaffolds, extract-free scaffolds, commercial dressing (Mepilex® foam), or sterile gauze as a control. On day 14, the wound area reduction and histological analysis (H&E and Masson's Trichrome) were assessed. Wound healing was

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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