Stem cell transplantation to treat type 2 diabetes

Stem cell transplantation to treat type 2 diabetes. Stem cell transplantation therapy provides new clinical progress for type 2 diabetes. The feasibility of stem cell treatment for type 2 diabetes is explored clinically. Diabetes (diabetes mellitus, DM) is a type of patients with insufficient insulin secretion or insulin resistance caused by a variety of pathogenic factors There is a metabolic disease characterized by chronic hyperglycemia.

Type 2 diabetes (type2diabetesmellitus, T2DM) is also known as non-insulin-dependent diabetes, due to β-cell dysfunction in the context of insulin resistance, it is often accompanied by a gradual decrease in insulin secretion. The hyposensitivity of insulin promotes increased production of glucose in the liver, and decreased absorption in muscle and adipose tissue, causing hyperglycemia. Defects in β-cell function affect the feedback regulation between insulin-sensitive tissues and cause imbalance in glucose homeostasis. Type 2 diabetes accounts for more than 90% of the total number of diabetic patients, and its causes are diverse, and the pathogenic mechanism is still unclear.

Traditional medical intervention methods are not satisfactory

At present, the main methods of blood sugar control for type 2 diabetes patients are oral hypoglycemic drugs and exogenous insulin supplements.

Exogenous insulin supplementation is mainly used for the treatment of type 1 diabetes. Long-term injections of exogenous insulin will lead to the risk of drug resistance and acute hypoglycemia. Patients with severe type 2 who have developed extensive drug resistance can be treated with islet transplantation. Dialysis and combined pancreas-kidney transplantation are required for patients with severe complications that lead to organ damage such as diabetic nephropathy and kidney failure.

5 major mechanisms of stem cells on diabetes:

1. The self-renewal characteristics of stem cells ensure that their sources can be expanded in large quantities;

2. The differentiation and regeneration of stem cells suggest that they can differentiate into pancreatic β cells to replace damaged cells;

3. The secretion of cytokines from stem cells regulates the islet microenvironment and improves the islet resistance;

4. Immune regulation of stem cells can reduce the inflammation of the pancreatic islets and improve the function of pancreatic β-cells;

5. The paracrine mechanism of stem cells can activate the body’s own tissue repair ability.

Stem cell therapy provides a new treatment strategy for type 2 diabetes

Bone marrow-derived hymal stem cells (bone marrow-derived hymal stem; cells, BM-MSCs) transplantation has a weak rejection response, has immunomodulatory and anti-inflammatory effects, and plays an important role in the treatment of autoimmune diseases. Therefore, it may be useful for type 1 diabetes Good therapeutic effect.

The mechanism of stem cell transplantation induction (BMSCs) into (IPCs) cells

Studies have shown that in animal models of diabetes, the differentiation of bone marrow mesenchymal stem cells (BMSCs) into pancreatic islet cells or pancreatic duct cells for treatment can effectively reduce blood sugar.

Xie et al. successfully induced the differentiation of human BM-MSCs into IPCs. These IPCs expressed multiple genes related to the development and function of pancreatic β-cells, including Glut2, PAX6, nestin, PDX1, NGN3, NKX6.1, ISL-1, Beta2/Neurod, insulin and glucagon. Gabr et al. also controlled diabetes in nude mice with streptozotocin by transplanting mature bone marrow mesenchymal stem cells.

Clinical case

research method

Researchers screened 10 patients with T2DM who were resistant to three oral antidiabetic drugs (sulfonylurea, metformin, and TZD) and the disease lasted for 5 years. They were treated with bone marrow at the duodenal artery through the femoral artery. Mesenchymal stem cell transplantation treatment.

Research result

After 6 months of treatment, insulin demand was reduced by more than 50%, HbA1c was reduced, and the level of C-peptide stimulated by glucagon was improved, and no serious adverse reactions were found. It shows that autologous bone marrow-derived stem cell transplantation is expected to be a safe and effective treatment method to improve β cell function in patients with T2DM.

Sum up

Restoring pancreatic islet function through stem cell transplantation provides new ideas for the treatment of diabetes. Stem cells are highly totipotent or pluripotent, can self-replicate and increase in vitro, and maintain the same population characteristics as Qing Dynasty cells. Using it to induce differentiation into pancreatic secretory cells with insulin-producing function can reduce or even get rid of patients’ long-term dependence on insulin.

Industry Progress

Inquiry about 76 clinical trials related to stem cell treatment of diabetes and its complications. It has entered Phase 1 and Phase 2 clinical trials in China, India, the United States and other countries. Table 1 lists several representative stem cell treatments related to diabetes. Invention project

The current treatment of diabetes is still limited by lifelong medication and the risk of hypoglycemia. In recent years, as stem cells have gradually been used in the clinical treatment of a variety of major diseases, the research on stem cell treatment of diabetes has also achieved great results.

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