10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Efficacy of Autologous Bone Marrow-Derived Mesenchymal Stem Cell and Mononuclear Cell Transplantation in Type 2 Diabetes Mellitus: A Randomized, Placebo-Controlled Comparative Study.

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Drugs targeting β-cells have provided new options in the management of T2DM; however, their role in β-cell regeneration remains elusive. The recent emergence of cell-based therapies such as autologous bone marrow-derived mesenchymal stem cells (ABM-MSCs) and mononuclear cells (ABM-MNCs) seems to offer a pragmatic approach to augment β-cell function/mass. This study aims to examine the efficacy and safety of ABM-MSC and ABM-MNC transplantation in T2DM and explores alterations in glucose-insulin homeostasis by metabolic studies. Thirty patients of T2DM with duration of disease ≥5 years, receiving triple oral antidiabetic drugs along with insulin (≥0.4 IU/Kg/day) with HbA1c ≤7.5%(≤58.0 mmol/mol), were randomized to receive ABM-MSCs or ABM-MNCs through targeted approach and a sham procedure (n = 10 each). The primary endpoint was a reduction in insulin requirement by ≥50% from baseline, while maintaining HbA1c <7.0% (<53.0 mmol/mol) during 1-year follow-up. Six of 10 (60%) patients in both the ABM-MSC and ABM-MNC groups, but none in the control group, achieved the primary endpoint. At 12 months, there was a significant reduction in insulin requirement in ABM-MSC (P < 0.05) and ABM-MNC groups (P < 0.05), but not in controls (P = 0.447). There was a significant increase in second-phase C-peptide response during hyperglycemic clamp in the ABM-MNC (P < 0.05) group, whereas a significant improvement in insulin sensitivity index (P < 0.05) accompanied with an increase in insulin receptor substrate-1 gene expression was observed in the ABM-MSC group. In conclusion, both ABM-MSCs and ABM-MNCs result in sustained reduction in insulin doses in T2DM. Improvement in insulin sensitivity with MSCs and increase in C-peptide response with MNCs provide newer insights in cell-based therapies.

          Related collections

          Author and article information

          Journal
          Stem Cells Dev.
          Stem cells and development
          Mary Ann Liebert Inc
          1557-8534
          1547-3287
          Apr 01 2017
          : 26
          : 7
          Affiliations
          [1 ] 1 Department of Endocrinology, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
          [2 ] 2 Department of Nephrology/Translational and Regenerative Medicine, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
          [3 ] 3 Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
          [4 ] 4 Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
          [5 ] 5 Department of Medicine, University of California , San Diego, La Jolla, California.
          [6 ] 6 Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
          [7 ] 7 Department of Pharmacology, Postgraduate Institute of Medical Education and Research , Chandigarh, India .
          [8 ] 8 Division of Endocrinology and Diabetes Research and Training Center , Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.
          Article
          10.1089/scd.2016.0275
          28006991
          eb714bdb-fe61-417b-bc05-630ebbdf1455
          History

          T2DM,insulin sensitivity,stem cells,β-cells
          T2DM, insulin sensitivity, stem cells, β-cells

          Comments

          Comment on this article