Abstract
BackgroundMesenchymal stem cell (MSC) therapy shows great promise for diabetic kidney disease (DKD) patients. Research has been carried out on this topic in recent years. The main goals of this paper are to evaluate the therapeutic effects of MSCs on DKD through a meta-analysis and address the mechanism through a systematic review of the literature.MethodAn electronic search of the Embase, Cochrane Library, ISI Web of Science, PubMed, and US National Library of Medicine (NLM) databases was performed for all articles about MSC therapy for DKD, without species limitations, up to January 2020. Data were pooled for analysis with Stata SE 12.ResultThe MSC-treated group showed a large and statistically significant hypoglycemic effect at 1 week, 2 weeks, 3 weeks, 1 month, 2 months, 3 months, and 6 months. Total hypoglycemic effect was observed (SMD = − 1.954, 95%CI − 2.389 to − 1.519, p < 0.001; I2 = 85.1%). The overall effects on serum creatinine (SCr) and blood urea nitrogen (BUN) were analyzed, suggesting that MSC decreased SCr and BUN and mitigated the impairment of renal function (SCr: SMD = − 4.838, 95%CI − 6.789 to − 2.887, p < 0.001; I2 = 90.8%; BUN: SMD = − 4.912, 95%CI − 6.402 to − 3.422, p < 0.001; I2 = 89.3%). Furthermore, MSC therapy decreased the excretion of urinary albumin. Fibrosis indicators were assessed, and the results showed that transforming growth factor-β, collagen I, fibronectin, and α-smooth muscle actin were significantly decreased in the MSC-treated group compared to the control group.ConclusionMSCs might improve glycemic control and reduce SCr, BUN, and urinary protein. MSCs can also alleviate renal fibrosis. MSC therapy might be a potential treatment for DKD.
Highlights
Diabetes mellitus (DM) is a chronic metabolic disease with a rising incidence rate, and its microvascular and macrovascular complications are associated with a large global burden of morbidity and mortality [1]
The results showed that transforming growth factor-β, collagen I, fibronectin, and αsmooth muscle actin were significantly decreased in the Mesenchymal stem cell (MSC)-treated group compared to the control group
MSC therapy might be a potential treatment for diabetic kidney disease (DKD)
Summary
Diabetes mellitus (DM) is a chronic metabolic disease with a rising incidence rate, and its microvascular and macrovascular complications are associated with a large global burden of morbidity and mortality [1]. Mesenchymal stem cells (MSCs) are being used systemically or locally to treat many diseases, as they exhibit great self-renewal and differentiation potential [4, 5]. Adult stem cells, the undifferentiated cells in differentiated tissues, can be isolated from the bone marrow, adipose tissue, umbilical cord blood, and deciduous teeth. MSCs have been used for tissue regeneration and repair [6], treatment of inflammatory disease [7], prevention of transplant rejection [8], and other clinical applications. Mesenchymal stem cell (MSC) therapy shows great promise for diabetic kidney disease (DKD) patients.
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