Stem cell transplantation for treatment of diabetes: our experiences in EMRI

IntroductionDiabetes mellitus is the most prevalent metabolic disorder. After traditional treatments, novel therapeutic strategies have brought remarkable progresses. For instance, cell-based therapy has been of great impact in managing patients with diabetes mellitus. Nowadays, mesenchymal stem cells (MSCs), as a type of adult stem cells, have been introduced as an attractive source for cellular therapy. Accordingly, the body of literature have supported the advantages of fetal tissue-derived stem cells over their adult counterparts such as greater differentiation in addition to their lower immunogenicity. In this regard, in 2007, researchers in Endocrinology & Metabolism Research Institute, for the first time in Iran, isolated hematopoietic stem cells(HSCs) from the fetal tissues and evaluated the therapeutic effects of HSCs and MSCs on diabetes in phase I and II clinical trials.MethodsApproximately 200 patients with diabetes aged 10-58 years old have been enrolled through several studies. An informed consent was obtained from each patient or his/her parents before their enrollment in the study. The patients entered the study according to inclusion/exclusion criteria after checking for viral infections including HCV, HBV, HIV, and urogenital infections. Patients were divided in tree groups: two intervention groups and placebo group. Groups received respectively fetal liver-derived cell suspension, autologous MSCs, and normal saline in specific dosage intravenously.ResultsIn the 6th month of the follow-up, there was a significant decrease in HbA1c levels in all groups without any rise in the fasting c-peptide and no other significant differences were seen in other variables between tree groups or within groups. However, none of the precipitants transiently or continuously became insulin free in the first year after transplantation.ConclusionsIt can be concluded that application of HSCs and autologous MSCs have beneficial effects on diabetes. However, although autologous transplantation of MSCs is a remarkable advantage, fetal stem cells are considered as more potent sources than adult stem cells. In this regard, more basic and clinical studies are needed to investigate the therapeutic effects of these novel promising strategies

کلیدواژه ها:

Diabetes mellitus ، Stem cell ، Liver ، Fetal