Advances in the differentiation of induced pluripotent stem cells into vascular cells for the treatment of diabetic microvascular disease

Abstract The core pathological mechanisms of diabetic microvascular diseases, such as nephropathy, diabetic retinopathy (DR), and neuropathy, involve the dysfunction and loss of microvascular endothelial cells (ECs), vascular smooth muscle cells (VSMCs), and pericytes (PCs). Conventional therapeutic approaches struggle to achieve structural repair and functional regeneration of damaged vessels. Induced pluripotent stem cell (iPSC) technology offers revolutionary prospects for an autologous, limitless source of functional vascular cells, significantly advancing regenerative medicine in the field of diabetic vascular complications. This review systematically summarizes recent developments in differentiating iPSCs into key microvascular cell types. Combined with advanced co-culture, three-dimensional (3D) modeling, organoids, and microfluidic chip technologies, these developments have not only deepened our understanding of diabetic microvascular pathology but also demonstrated substantial clinical potential in cell transplantation therapies, vascular tissue engineering constructs, and personalized drug screening.