Abstract

Diabetic ulcers often present challenges in healing or may heal incompletely without the restoration of proper function. Piper betle L. is recognized as a valuable traditional medicine for treating open wounds due to its antibacterial and anti-inflammatory properties, as well as its ability to stimulate fibroblast proliferation. Additionally, adipose-derived stem cells (ADSCs) have the capacity to self-renew and differentiate into various cell types, facilitating the repair of wounded organs in the body. Therefore, this study evaluates the therapeutic effect of combining ADSCs with Piper betle L. extract on the process of healing chronic wounds. Mice with chronic diabetes and induced ulcers were randomly divided into four groups: Group 1 (control, n=15), Group 2 (Piper betle L. extraction, n=15), Group 3 (ADSCs injections, n=15), and Group 4 (ADSCs injections combined with Piper betle L. extraction, n=15). The wounds in the control group, the Piper betle L. extraction group, and the ADSCs group healed on days 18, 17, and 16, respectively. However, the group treated with ADSCs combined with Piper betle L. extraction healed as early as the 14th day. Piper betle L. extraction and ADSCs are regarded as paracrine signals that promote the proliferation and migration of fibroblasts and keratinocytes, leading to faster healing. Moreover, Piper betle L. possesses antibacterial properties, thus, when combined with ADSCs in treatment, it accelerates the healing process of diabetic wounds.