A review of clinical trials: mesenchymal stem cell transplant therapy in type 1 and type 2 diabetes mellitus.

IF 1.9 Q4 CELL BIOLOGY American journal of stem cells Pub Date : 2018-10-01 eCollection Date: 2018-01-01
Jang Cho, Matthew D'Antuono, Michael Glicksman, Jing Wang, Jacqueline Jonklaas
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Abstract

Type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) are widely prevalent metabolic diseases with differing pathologies. T1DM manifests due to autoimmune destruction of the pancreatic beta cells, resulting in a diminished secretion of insulin. T2DM originates from a state of insulin resistance, resulting in hyperglycemia and reduction in beta cell mass. Both diseases can cause severe health consequences. Despite the globally increasing prevalence of both T1DM and T2DM there remains to be a medically defined cure for either of these diseases. Recently, mesenchymal stem cells (MSCs) have been proposed as a possible curative treatment method. In this review, we explain the molecular mechanisms underlying MSCs and their potential ability to treat T1DM and T2DM. We describe the capability of MSCs to differentiate into insulin-producing cells and regenerate pancreatic beta cells, as well as assess their role in modulating the immune system. Lastly, we evaluate the current literature focusing on the clinical application of MSC transplantation in T1DM and T2DM. Despite the favorable results, study designs and analyses cast doubt on the effectiveness of MSCs for the management of T1DM. Conversely, the positive metabolic effects consistently demonstrated in the literature offer hope for MSCs as a treatment for T2DM, at least in the short-term.

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临床试验综述:间充质干细胞移植治疗1型和2型糖尿病。
1型糖尿病(T1DM)和2型糖尿病(T2DM)是广泛流行的代谢性疾病,具有不同的病理。T1DM的表现是由于自身免疫破坏胰腺细胞,导致胰岛素分泌减少。T2DM起源于胰岛素抵抗状态,导致高血糖和β细胞质量减少。这两种疾病都会造成严重的健康后果。尽管全球范围内T1DM和T2DM的患病率都在增加,但对于这两种疾病中的任何一种,医学上仍然没有明确的治愈方法。最近,间充质干细胞(MSCs)被认为是一种可能的治疗方法。在这篇综述中,我们解释了MSCs的分子机制及其治疗T1DM和T2DM的潜在能力。我们描述了间充质干细胞分化为胰岛素生成细胞和再生胰腺β细胞的能力,并评估了它们在调节免疫系统中的作用。最后,我们评估了目前关于间充质干细胞移植在T1DM和T2DM中的临床应用的文献。尽管结果良好,但研究设计和分析对MSCs治疗T1DM的有效性提出了质疑。相反,文献中一致证明的积极代谢作用为MSCs作为T2DM治疗提供了希望,至少在短期内是这样。
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