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

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.

Multiple pretreatments can effectively improve the functionality of mesenchymal stem cells

“…MSCs have emerged as a prominent cell source for SC therapy, owing to their renewable nature, immunomodulatory properties, minimal risk of tumorigenesis and lack of ethical constraints[ 12 ]. Many subtypes of MSCs, such as adipose-derived MSCs, human umbilical MSCs (HUMSCs), and bone marrow MSCs are eligible for clinical use, without significant functional abnormalities or side effects[ 11 , 13 , 14 ]. MSCs are primary plastic adherent cells with immense proliferative potential and the ability to self-renew and differentiate.…”

“…The potential for MSCs as a cell-based therapy in treating moderate immunologic disorders and regeneration has been well clarified, and MSCs are the most chosen SCs in clinical treatment[ 9 ]. MSCs can be derived from various tissues, including bone marrow, adipose tissue, Wharton’s Jell, dental pulp, menstrual blood and umbilical cord blood gleaned efficiently[ 10 , 11 ]. Although MSCs derived from different tissues share the same basic functional characteristics, there are still differences in their functional strengths, such as cell size, proliferative potential, secreted cytokines, and immunosuppression.…”