Stem cell treatment of diabetes, good news for 460 million patients!
2020-09-21
Recently, well-known entertainment brokers cut the stomach to treat diabetes aroused heated discussions. Many people have speculated that she had undergone gastric surgery to lose weight. In fact, she was done to treat 6 years of diabetes. The purpose of the surgery was to lower blood sugar quickly.
Can stomach cutting really treat diabetes? At present, the commonly used clinical gastrectomy operations include laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. Both of these operations can reduce the weight of obese patients and alleviate obesity-related complications. Stomach surgery was originally used to treat morbid obesity, but it also helps control blood sugar. In 2009, in the American Diabetes Association (ADA) Type 2 Diabetes Treatment Guidelines, scientists officially listed bariatric surgery as one of the measures to treat obesity type 2 diabetes.
Nearly 460 million people with diabetes worldwide
Diabetes is a metabolic disorder characterized by hyperglycemia. It is also the third largest non-communicable chronic disease in humans after tumors and cardiovascular diseases. Currently, there are about 463 million patients worldwide.
Diabetes and its complications seriously threaten human health, such as: diabetic kidney disease, diabetic retinopathy and diabetic neuropathy. The main incidence of type 1 diabetes is adolescents and children, which are characterized by decreased insulin secretion and hyperglycemia due to the destruction of pancreatic β-cells. Type 2 diabetes is caused by genetic and environmental factors, and is characterized by pancreatic β-cell dysfunction and insulin resistance. In my country, type 2 diabetes patients account for 95%, and its incidence is increasing year by year. Although improvements in the synthesis and delivery of recombinant insulin have significantly reduced the morbidity and mortality of diabetes, there is currently no cure for diabetes.
New diabetes treatments are under development
At present, there are countless ways to treat diabetes, but traditional hypoglycemic drugs and insulin can only treat symptomatically and only temporarily maintain the balance of blood sugar. It is difficult to prevent the progressive decline of β-cell function and the development of diabetes complications. It is urgent and important to develop new treatments and drugs on the existing basis. Stem cells have become one of the research hotspots in this field.
Stem cells are cells that can continuously renew themselves and have the potential for multidirectional differentiation. Mesenchymal stem cells are the most studied type of stem cells in the treatment of diabetes and its complications. Mesenchymal stem cells are adult stem cells with multidirectional differentiation potential. They are derived from almost all types of tissues in the human body, such as bone marrow, blood, umbilical cord, placenta, skeletal muscle tissue, liver tissue, and adipose tissue. Studies have confirmed that mesenchymal stem cells can differentiate into non-mesoderm cells in vitro, including pancreatic islet-like cells, neuron-like cells and hepatocytes.
Why can stem cells treat diabetes?
So far, there have been many reports on the treatment of type 1 diabetes with mesenchymal stem cells. The treatment method has gradually developed from co-transplantation of mesenchymal stem cells and pancreatic islet cells to cell-free transplantation. Clinical research on the treatment of type 2 diabetes with stem cells is also developing year by year.
So, in what ways can stem cells treat diabetes?
First, studies have found that mesenchymal stem cells have significant effects on improving the function of pancreatic islets and liver glucose and lipid metabolism in diabetic patients, as well as reducing blood sugar.
The first clinical study of stem cell treatment of type 2 diabetes was about mesenchymal stem cells. The researchers combined intrapancreatic mesenchymal stem cell infusion with hyperbaric oxygen therapy, and observed the patient’s metabolic parameters during the one-year follow-up of the trial. Obviously improved, and the demand for insulin is also greatly reduced.
Clinical trials have found that after one year of autologous stem cell transplantation for 25 patients with type 2 diabetes, the blood glucose level of the diabetic patients is effectively controlled, the function of pancreatic β-cells is improved, and the insulin requirement is reduced [1]. Studies have also found that mesenchymal stem cell infusion can effectively reduce blood glucose levels in type 2 diabetic rat models, while restoring β-cell function and number, improving peripheral insulin resistance and inhibiting liver glycogen decomposition [2].
Second, more and more evidences indicate that mesenchymal stem cells achieve their therapeutic effects mainly through paracrine signaling, that is, mesenchymal stem cell exosomes.
Exosomes are extracellular nanoparticles with a lipid bilayer membrane, which are small vesicles that are combined with the cell membrane to be released outside the cell after they collapse into the cell to form multivesicular bodies. It contains abundant protein, RNA and DNA, which can directly deliver protein, mRNA, etc. from secreting cells to recipient cells.
Compared with mesenchymal stem cells, exosomes have a lower risk of immunogenicity and aneuploidy, and are easier to store and transport. At the same time, the ability of exosomes to achieve mass production makes them more attractive therapeutic agents. Researchers found that umbilical cord mesenchymal stem cell exosomes can reduce blood sugar levels in type 2 diabetic rat models and improve insulin secretion [3].
Third, more and more studies have shown that stem cells also play an important role in the treatment of diabetes complications.
It is understood that there are currently more than 200 clinical research projects related to stem cell treatment of diabetes. Many domestic and foreign clinical trials are also ongoing or have been proven effective, such as: mesenchymal stem cells for diabetic foot ulcers, umbilical cord mesenchymal stem cells for type 2 diabetic nephropathy, autologous stem cell transplantation for diabetic retinopathy, and so on. In order to evaluate the effectiveness and safety of stem cells in the treatment of diabetic complications, some medical institutions also recruit volunteer subjects for clinical trials, such as the "Umbilical Cord Mesenchymal Stem Cells for Type 2 Diabetic Nephropathy" project of the Department of Endocrinology, South Hospital of Shanghai Oriental Hospital, etc. .
Outlook
At present, diabetes treatment has become a major public health challenge. It is estimated that by 2040, there will be more than 600 million people with diabetes. Traditional hypoglycemic drugs and insulin injections cannot cure diabetes, and the quality of life of patients cannot be completely improved. Based on the fact that stem cell therapy is gradually recognized as a promising treatment strategy for diabetes, it is believed that stem cells can bring unlimited possibilities for the eradication of diabetes in the future.
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