Mesenchymal stem cells (MSCs) are self-renewing multipotent cells that have the capacity to secrete multiple biologic factors that can restore and repair injured tissues. Preclinical and clinical evidence have substantiated the therapeutic benefit of MSCs in various medical conditions. Currently, MSCs are the most commonly used cell-based therapy in clinical trials because of their regenerative effects, ease of isolation, and low immunogenicity. Experimental and clinical studies have provided promising results using MSCs to treat diabetes. This review will summarize the role of MSCs on tissue repair, provide emerging strategies to improve MSC function, and describe how these processes translate to clinical treatments for diabetes.
WHICH DIABETIC PATIENTS WOULD BENEFIT FROM MSC THERAPY?
Given the findings in the meta-analysis by El-Badawy and El-Badri, patients with diabetes type I and II can benefit from MSC therapy (El-Badawy & El-Badri 2016). Furthermore, the authors discuss that patients in the early stages of diabetes may be among the best candidates for stem cell treatment. Although 22 studies were included in this review, only 6 studies (total of 112 patients) used MSCs, of which only 2 studies focused on early-onset diagnosis (total of 49 patients). Still, the four studies in patients with chronic diabetes type I/II (average 8-year duration) had improvements in diabetic measures, which strongly justifies further studies to clearly delineate potential diabetic populations that may benefit from MSC therapy.
Given their ability to mitigate fibrosis, modulate inflammation, and promote vascular growth, MSCs provide a promising therapeutic strategy for patients with endocrine disorders. The boundless availability of MSCs from various tissues and organs, as well as their beneficial properties, reinforce the widespread use of these cell types in regenerative studies. Although our understanding of factors mediating the function of MSCs has improved, there is still much that is not clearly understood. For instance, newer evidence is demonstrating that preconditioning/genetically altering MSCs may influence their function and thereby translate to improved clinical effects. Although large studies examining human application of MSCs are still lacking, initial studies in endocrine-focused studies demonstrate the potential for a paradigm shift. In sum, regenerative medicine remains a new and exciting field of research that holds much promise into the treatment of patients with endocrinologic diseases of all ages.
[By Celebre Pro Medic Sdn Bhd 20220218]