ALL STEM CELLS

Bone Marrow-Derived Stem Cell Transplantation for the Treatment of Insulin-Dependent Diabetes

The bone marrow is an invaluable source of adult pluripotent stem cells, as it gives rise to hematopoietic stem cells, endothelial progenitor cells, and mesenchymal cells, amongst others. The use of bone marrow-derived stem cell (BMC) transplantation (BMT) may be of assistance in achieving tissue repair and regeneration, as well as in modulating immune responses in the context of autoimmunity and transplantation. Ongoing clinical trials are evaluating the effects of BMC to preserve functional beta-cell mass in subjects with type 1 and type 2 diabetes, and to favor engraftment and survival of transplanted islets. Additional trials are evaluating the impact of BMT (i.e., mesenchymal stem cells) on the progression of diabetes complications. This article reviews the progress in the field of BMC for the treatment of subjects with insulin-dependent diabetes, and summarizes clinical data of pilot studies performed over the last two decades at our research center by combining allogeneic islet transplantation with donor-specific BMC.

Keywords: bone marrow-derived stem cell, diabetes, mesenchymal stem cell, transplant, islet transplantation, beta-cell replacement, chimerism, clinical trial, tolerance

Cellular therapies for the treatment of diabetes may enable the restoration of glucose-sensing and -secreting machinery to attain physiologic metabolic control. Restoration of beta-cell function is an important therapeutic goal for the treatment of patients with insulin-dependent diabetes [1]. Pancreatic islets are highly specialized glucose sensors that finely regulate glucose metabolism in normal conditions. Functional islet mass becomes lost in an autoimmune process that selectively targets insulin-producing cells in type 1 diabetes (T1D). In type 2 diabetes (T2D), the loss is due to metabolic exhaustion. In these patients, metabolic control throughout the day is very difficult to achieve by current medical therapy using exogenous insulin supply.

Orgin : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989787/