Chronic non-healing wounds represent a major source of morbidity, disability, and mortality
in diabetic patients. Diabetes is the leading cause of non-traumatic limb amputations
worldwide. Many patients with ischemic or neuroischemic wounds are not candidate to
surgical/endovascular revascularization, owing to anatomical vascular reasons or for the
underlying conditions and co-morbidities. Therefore, identification of novel medical
treatment strategies to improve wound healing in diabetic patients is a major challenge for
clinicians, researchers, and health care systems.
Defects in bone marrow (BM)-derive stem and progenitor cells, including EPCs (endothelial
progenitor cells), contribute to diabetic complications. Stem cell mobilizing agents have
been previously studied as an adjunctive therapy for critical limb ischemia and chronic
non-healing wounds in diabetic and non-diabetic patients, as well as for the treatment of
diabetic wound infections . Meta-analyses of such studies indicate that stem cell
mobilization in these clinical conditions is safe and potentially effective in improving
surrogate outcome measures and hard endpoints (such as rates of wound healing and
amputation).
This study plans to evaluate whether a single injection of Plerixafor improves wound healing
in diabetic patients with stage III-IV (neuro)ischemic wounds.