الفهرس 
Introduction And Aim Of The WorkOnly 14 pages are availabe for public view
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Abstract
Patients with diabetes mellitus usually develop chronic wounds because wound healing is impaired. With diabetes becoming more prevalent, this has a negative impact on the patient and the healthcare system and will soon be a significant medical, social, and financial load. Therefore, it would seem important to find therapeutic alternatives to the existing accessible treatments that cannot assure a prompt and certain reparative procedure.
For the treatment of persistent wounds that do not heal, cell-based therapy is an appealing option.
(ASCs) were chosen in this study due to the ease with which they could be isolated and the fact that there were a lot of them, making them a viable source for wound healing and regeneration.
Since it is simple to make, can be kept for a long time in storage, and contains a variety of paracrine elements that might promote wound healing, conditioned media (CM) collected from ASCs culture has been proposed as an alternate strategy for treating diverse wounds.
Growth factors (GFs), which are unprocessed biological mediators, play a part in tissue regeneration and repair. Many GFs necessary for cell proliferation and differentiation are carried by platelets. A low-cost technique to provide significant amounts of autologous GFs is platelet-rich plasma (PRP).
This work used histological, immunohistochemical, and biochemical approaches to examine the effects of various new therapies—ASCs, CM, and PRP-on a rat model of diabetic wound healing and explain the mechanisms involved in those effects.
To demonstrate these roles, 105 male albino rats weighing between 150 and 250 g and aged 8 to 10 weeks were used. Six were used to prepare ASCs, nine were used to obtain PRP, and 90 were divided into five equal groups of 18 rats each. Two linear incisional wounds measuring 1.5 cm each were made on the backs of each rat in group I (sham control), which consisted of non-diabetic rats, and the wound was injected with saline. In order to induce type I diabetes, group II (the diabetic wound non treated group), group III (the diabetic wound + ASCs treatment group), group IV (the diabetic wounded + CM treated group) and group V (the diabetic wounded + PRP treated group).
Dorsal skin tissue was removed at the 3rd, 7th, 14th day of incision and processed for: L.M, immune-histochemical, biochemical, and morphometric studies.
The results of the current study revealed that:
• The hematoxylin and eosin results at the 3rd day of incision showed inflammatory cells infiltration and skin degeneration at the site of wound in the sham control, diabetic, CM, and PRP groups, while the ASCs group showed regression of the inflammatory cells. Results at the 7th day of incision showed that the diabetic group was widely gapped with failure of epithelialization, minimal granulation tissue filled the wound gap, and inflammatory cells stilled present, while the CM and PRP groups showed incomplete epithelialization, new vessels formation, and granulation tissue filled the damaged dermis beneath the wound but inflammatory cells still filling the wound gap. Injection of ASCs in group III improved the previous histological changes with complete epithelialization closed the wound gap and regeneration of skin appendages which was better than that of the sham control. Results at the 14th day of incision showed failure of wound healing in the diabetic group, while the Sham control, ASCs, CM, and PRP treated groups showed complete wound healing nearly similar to the structure of normal skin.
• The Masson´s trichrome results showed significant decrease the mean area percent of collagen deposition in the diabetic group compared to other treated groups at different time points. The ASCs group showed deposition of fine collagen fibers at the papillary dermis and coarse collagen bundles run in different direction in the reticular dermis which resembles the structure of normal skin. The CM group showed deposition of fine collagen fibers at day 3 then increased gradually at day 7 and 14. The PRP group showed deposition of fine collagen fibers at day 3 then become thickened and coarse at the 7th and 14th day.
• The Toluidine blue results showed decrease of the total mast cells count in the diabetic group at day 3, few cells at day 7, and increased their number with degranulated cells at day 14, while the treated groups nearly similar to the sham control which showed early presence of many degranulated mast cells and their numbers decrease gradually at day 7 and 14.
• The Immunohistochemical and morphometrical results showed that the mean number of anti-CD68 immune-reactive cells decreased significantly in the treated groups when compared to the diabetic groups. while the diabetic group showed delayed appearance of CD31 immune reactive cells until the 14th day. The results of CD31 showed a significant increase in the mean area fraction of CD31 positive cells in the ASCs at day 3 compared to all other groups, then decreased gradually. The mean number of immune-reactive cells significantly increased in the treated groups when compared to the diabetic group, according to the results of -SMA. When the treated group was compared to the ASCs and CM groups, the PRP group shown a substantial increase, whereas the ASCs group demonstrated a significant increase.
• The biochemical results confirmed the earlier findings: the ASCs had a significant decrease compared to the CM and PRP groups, the PRP showed a significant decrease compared to the CM group, and the Arg-1 results showed a significant increase in their mean values in the treated groups compared to the diabetic groups, comparing the treated group. confirmed the earlier findings; the TNF- and NO results showed a significant decrease in their mean values in the treated groups compared to the diabetic groups, comparing the treated group, the ASCs had a significant decrease compared to the CM and PRP groups, the PRP showed a significant decrease compared to the CM group, while the Arg-1 showed a significant increase in their mean values in the treated groups compared to the diabetic groups, comparing the treated group.
It was determined that the ASCs treated group had the best healing results. The PRP group was rated as the second-best healing group, while the CM treated group performed better than the diabetic group despite displaying a lower degree of healing.