Erythropoietin-overexpressing mesenchymal stem cells accelerate diabetic wound healing via steroid signaling pathway modulation

BACKGROUND Chronic non-healing diabetic wounds are driven by persistent inflammation, impaired fibroblast function, and defective neovascularization. Mesenchymal stem cell (MSC)-based therapies show promise, but their efficacy is limited by suboptimal paracrine and immunomodulatory activity. AIM To determine whether erythropoietin-overexpressing MSCs (EPO-MSCs) enhance diabetic wound healing and to delineate the underlying immune mechanisms, with particular focus on serum amyloid A3-positive (Sa