MESENCHYMAL STEM CELLS IN REGENERATIVE MEDICINE: A HOPE FOR TYPE 1 DIABETES CURE

 

Stem cells are a type of undifferentiated cells that have the ability to develop into various cell types. They have two main properties, to self-renew and differentiate into other cells. Stem cells have a wide range of applications in regenerative medicine, treatment of blood disorders,drug testing, personalised medicine, gene therapy and many more. Mesenchymal stem cells (MSCs) offer a solution to the problems associated with islet transplantation. MSCs are widely accessible from bone marrow, adipose tissue, and umbilical cord blood.

Diabetes mellitus, a chronic metabolic disorder that increases the blood glucose (sugar) level in the blood. Type-1 diabetes mellitus is an autoimmune disorder where the beta cells in the pancreas that produce insulin are mistakenly attacked by the body’s immune system, due to which the body produces no insulin in children or young adults. Diabetes in total affects 25.8 million people, out of which 5-10% are affected by type-1 diabetes. 

Administering insulin to the patient every day can result in the most effective glycemic control, but they ultimately end up with a lot of side effects. Hence, stem cell therapy followed by islet transplantation holds the potential to be an optimal and permanent therapy for T1D.

Mesenchymal stem cells have the capacity to travel to the damaged tissue, making them useful for delivering therapeutic proteins. Unlike treatments that wipe out immune cells, MSCs work by affecting how antigens are presented and how T cells are activated, using secreted factors like HGF, IL-10, and IDO. In a clinical trial, MSCs were injected into the liver of a patient and a significant and well tolerated immune response was observed due to their ability to boost the body's own immune suppressing cells for islet transplantation. It was seen to be a success in a clinical trial with a diabetic mice and humanised mouse model. The TNF blocking protein gene and IL-1 blockers gene can also be added to the MSCs that are known to reduce inflammation in diabetic mice and protect islet transplantation respectively.

Another method is to directly produce the insulin producing cells as the availability of islets may not always be available. It is yet to be determined if the MSCs directly produce insulin producing cells or they indirectly help in the production, but there seems to be an increase in the number of cells when the MSCs are injected. Key factors in this process include Pdx-1, Ngn3, Pax4, Arx, GLP-1, and EGF, all of which help guide MSCs to become β cells. Some studies also found MSCs could turn into cells that produce other pancreatic hormones like glucagon and somatostatin, suggesting they might be used to build full islets in the lab. Recently, progress in tissue engineering suggested that a biocompatible scaffold might be necessary for the in vitro generation of artificial islets with functional vasculature from stem cells. 

MSCs are known to be a powerful tool for biological research and regenerative medicine, since they are easier to isolate, expand and genetically modify. Though there are a lot of advantages, the safety concerns regarding developing the MSCs prevail. Through research and in-depth studies it may eventually pave the way to treat and cure Type 1 Diabetes.

IMAGE CREDIT

Cromos Pharma, https://images.app.goo.gl/td8ABmmSm84RKgMh6

REFERENCE

Wu H, Mahato RI. Mesenchymal stem cell-based therapy for type 1 diabetes. Discovery medicine. 2014 Mar 7;17(93):139-43.