Mesenchymal Stem Cell Transplantation in Type 1 Diabetes Treatment: Current Advances and Future Opportunity.

Jie Liu, Xin-Xing Wan, Sheng-Yuan Zheng, Md Asaduzzaman Khan, Hui-Hong He, Yu-Xing Feng, Jing-Ge Xiao, Yu Chen, Xi-Min Hu, Qi Zhang, Kun Xiong
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Abstract

Type 1 Diabetes (T1D) is characterized by hyperglycemia, and caused by a lack of insulin secretion. At present there is no cure for T1D and patients are dependent on exogenous insulin for lifelong, which seriously affects their lives. Mesenchymal stem cells (MSCs) can be differentiated to β cell-like cells to rescue the secretion of insulin and reconstruct immunotolerance to preserve the function of islet β cells. Due to the higher proportion of children and adolescents in T1D patients, the efficacy and safety issue of the application of MSC's transplant in T1D was primarily demonstrated and identified by human clinical trials in this review. Then we clarified the mechanism of MSCs to relieve the symptom of T1D and found out that UC-MSCs have no obvious advantage over the other types of MSCs, the autologous MSCs from BM or menstrual blood with less expanded ex vivo could be the better choice for clinical application to treat with T1D through documentary analysis. Finally, we summarized the advances of MSCs with different interventions such as genetic engineering in the treatment of T1D, and demonstrated the advantages and shortage of MSCs intervened by different treatments in the transplantation, which may enhance the clinical efficacy and overcome the shortcomings in the application of MSCs to T1D in future.

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间充质干细胞移植治疗1型糖尿病:当前进展和未来机遇。
1型糖尿病(T1D)以高血糖为特征,由胰岛素分泌不足引起。目前T1D尚无治愈方法,患者终身依赖外源性胰岛素,严重影响了他们的生活。间充质干细胞(MSCs)可以分化为β细胞样细胞,以拯救胰岛素的分泌,并重建免疫耐受,以保持胰岛β细胞的功能。由于儿童和青少年在T1D患者中的比例较高,本综述中的人类临床试验主要证明并确定了MSC移植在T1D中应用的疗效和安全性问题。然后我们阐明了MSCs缓解T1D症状的机制,并通过文献分析发现UC MSCs与其他类型的MSCs相比没有明显的优势,从骨髓或经血中提取的离体膨胀较小的自体MSCs可能是临床应用治疗T1D的更好选择。最后,我们总结了基因工程等不同干预措施对骨髓间充质干细胞治疗T1D的进展,并论证了不同治疗方法对骨髓间质干细胞在移植中的优势和不足,这可能会提高临床疗效,并克服未来MSCs在T1D应用中的不足。
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