Application of Fetal Stem Cells in Diabetes: Iran’s Experience
Year: 2015
Type: article
Abstract: Diabetes mellitus is a chronic and disabling disease, which imposes a substantial burden on public health in both developing and developed countries. Patients suffering from diabetes mellitus are at higher risk of being affected by different complications related to cardiovascular, renal, ophthalmic, neurological, cerebrovascular, and peripheral vascular systems (1). Moreover, mortality rate of diabetes is considerably high and it is reported that worldwide, 3% of deaths can be attributed to diabetes (2).Currently, based on the reports of the WHO, more than 220 million people suffer from diabetes in the world (3). In the Middle East, recent reports from different countries in the region indicate that the prevalence of both type 1 and type 2 diabetes are alarmingly increasing (4, 5).To date, available treatment options for diabetes, which include oral antidiabetic agents and insulin therapy, do not fully prevent from diabetes-related complications (6, 7). However, it is demonstrated that preservation or restoration of pancreatic beta cell's function, even to small extents, may significantly prevent from short-term and long-term complications of diabetes (8-13). Moreover, side effects of antidiabetic agents are intolerable for some patients and insulin therapy is cumbersome. Besides, it is difficult to maintain blood sugar levels within the normal range with the use of currently available conventional diabetes treatment strategies. Therefore, it is imperative to develop new strategies for treatment of diabetes with the objective of preservation or restoration of insulinsecreting beta cells.Hitherto, several potentially curative approaches are developed for treatment of diabetes. One such approach is immunosuppression by means of either immunosuppressive drugs or monoclonal antibodies. However, complete cure has remained elusive and adverse effects far outweighed benefits (8, 14-18). Although limited by shortage of donors and defects in the currently available immune suppression methods, whole pancreas transplantation is considered as another curative option for treatment of diabetes with quite acceptable safety and effectiveness (19, 20). Pancreatic islet cell transplantation is yet another promising curative option for diabetes with a favorable future although the procedure is hindered by shortage of donors and its progress is dependent on discovery of new methods to induce immune tolerance to the donor beta cells (21). In Iran, Endocrinology and Metabolism Research Institute of Tehran University of Medical sciences has attained remarkable achievements in this field and has even established a pancreatic islet transplantation facility for islet isolation with the first successful isolation performed in 2010 (22).Stem cells, believed to have the potential to be used as an alternative to pancreatic islet cells, are undifferentiated cells, which are capable of proliferation, regeneration, and conversion to differentiated cells (23). They can be harvested from two different sources on which base they are broadly categorized into two different categories: adult and embryonic stem-cells.Since 1980s when the science of stem-cell research evolved significantly, many different diseases have been cured with the use of autologous transplantation of adult stem-cells and the technique is now used more often than allotransplantation considering its low immunogenicity and minimum requirement for immunosuppression (24). Autologous transplantation of adult stemcells has already been used for treatment of type 1 DM with considerable improvement in daily insulin dose and c-peptide levels (25-27). In one study carried out by our institute in 2010, autologous transplantation of mesenchymal stem cells, which were obtained through bone marrow aspiration and injected in two sessions, demonstrated significant decrease in the required insulin dose in a few patients with type-1 diabetes (28). The results of our study, which were presented as a poster presentation at the Endocrine Society's 95th Annual Meeting and Expo (Endo 2013) in San Francisco, demonstrated no side effects and the observed reduction in total daily insulin dose in a few patients was significant. …
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2189757343