Introduction: Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia and is caused by a defect in the secretion or use of insulin or defective insulin activity. According to the statistics of the World-Health-Organization, about 422 million people worldwide have diabetes. Diabetic foot ulcers (DFUs) are one of the most common complications of diabetes mellitus. (About 19-34% of diabetic patients suffer from DFUs during their lifetime.) DFU describes a break in the skin of the foot in a person with diabetes that does not heal quickly. The ability to self-renew and differentiate into various types of cells are the main characteristics of stem cells, which make cell therapy a new alternative for tissue repair and regeneration. The possibility of using mesenchymal stem cells (MSCs) as a cell source for tissue engineering applications including bone regeneration, cartilage regeneration, and DFU has been shown based on the role of these cells in wound healing. In recent decades, new therapeutic methods based on MSCs have been designed to solve the medical problems of patients with incurable DFU. Although cell therapy seems simple in theory, due to the non-homogeneous nature of cells, existing test methods may have more errors than expected. Scientists believe that artificial-intelligence (AI) can help provide precise measurements to solve this complexity, which could be a big step in cell-therapy for chronic diseases such as DFU. In short, AI is the science of building intelligent machines that can imitate human behavior using learning and decision-making abilities with minimal external intervention. Considering the fact that there has been no study on the use of AI in the cell therapy of this chronic complication of diabetes, the purpose of this review article is to propose the use of AI in the cell therapy of diabetic foot ulcers.
Methods: For this study, using PubMed, Medline, ScienceDirect, and Web of Science search engines, we studied articles related to the use of AI in cell therapy and cell therapy for diabetic foot ulcers.
Results: AI can analyze large data sets in a short time and lead to improved patient treatment. By implementing AI algorithms, researchers can find cells that are most likely to grow, proliferate, and differentiate in target tissues. Researchers are using artificial-intelligence in cell therapy to predict the therapeutic potential of cells to develop patient-specific regenerative therapies. Also, artificial-intelligence is vital for improving the quality of production and delivery of stem cells and can help in determining the viability, effectiveness, efficiency, and safety of stem cells. Using methods such as patient classification based on machine learning to identify patients who respond to treatment or not before treatment with stem cells, which can reduce treatment costs, is one of the effects of this science in cell therapy. A paper published in 2021 stated that advanced AI algorithms should be used to manage large volumes of medical data sets that include individual genetic characteristics, clinical findings, laboratory biomarkers, and computational analyses in stem cell therapy. For example, in a 2020 study on cell therapy for age-related macular degeneration, artificial-intelligence was used to predict tissue function based on the shape characteristics of individual donor cells, with only one error out of 36 predictions. which shows that this non-invasive method can minimize errors and prevent adverse effects in the field of cell-therapy.
Conclusion: In recent years, artificial-intelligence-based technologies have been developed to improve remote monitoring of diabetic foot ulcers using mobile phone applications. Aspects such as timely screening to identify the risk of leg ulcers (or even worse, amputation) have also been addressed through this science. It has been shown that AI can use real-world data to create models capable of predicting and medically diagnosing diabetes and its complications, such as diabetic foot ulcers. However, despite the large number of diabetic patients who are involved in DFU, as well as the importance of stem cells in the treatment and control of these patients and the prominent role of AI in tuberculosis therapy, no study has been conducted on this issue. Emphasizing the importance of using AI in cell-therapy and also using cell-therapy in the treatment process of diabetic foot ulcers, this review article suggests the use of artificial-intelligence in the treatment of diabetic foot ulcers.