Abstract
The worldwide increase in the prevalence of Diabetes mellitus (DM) has highlighted the need for increased research efforts into treatment options for both the disease itself and its associated complications. In recent years, mesenchymal stromal cells (MSCs) have been highlighted as a new emerging regenerative therapy due to their multipotency but also due to their paracrine secretion of angiogenic factors, cytokines, and immunomodulatory substances. This review focuses on the potential use of MSCs as a regenerative medicine in microvascular and secondary complications of DM and will discuss the challenges and future prospects of MSCs as a regenerative therapy in this field. MSCs are believed to have an important role in tissue repair. Evidence in recent years has demonstrated that MSCs have potent immunomodulatory functions resulting in active suppression of various components of the host immune response. MSCs may also have glucose lowering properties providing another attractive and unique feature of this therapeutic approach. Through a combination of the above characteristics, MSCs have been shown to exert beneficial effects in pre-clinical models of diabetic complications prompting initial clinical studies in diabetic wound healing and nephropathy. Challenges that remain in the clinical translation of MSC therapy include issues of MSC heterogeneity, optimal mode of cell delivery, homing of these cells to tissues of interest with high efficiency, clinically meaningful engraftment, and challenges with cell manufacture. An issue of added importance is whether an autologous or allogeneic approach will be used. In summary, MSC administration has significant potential in the treatment of diabetic microvascular and secondary complications but challenges remain in terms of engraftment, persistence, tissue targeting, and cell manufacture
Highlights
Diabetes mellitus (DM) is a heterogeneous group of metabolic disorders characterized by hyperglycemia with impaired metabolism of carbohydrate, fat, and proteins as a result of defects in insulin secretion, insulin action, or both [1]
Chronic hyperglycemia in diabetes leads to various metabolic, hormonal, and physiologic alterations in the body, which further develop a number of secondary complications, which are responsible for major morbidity and mortality [6]
Mesenchymal stromal cells have been highlighted as a promising regenerative therapy due to their multipotency and due to their paracrine secretion of angiogenic factors, cytokines, and immunomodulatory substances
Summary
Diabetes mellitus (DM) is a heterogeneous group of metabolic disorders characterized by hyperglycemia with impaired metabolism of carbohydrate, fat, and proteins as a result of defects in insulin secretion, insulin action, or both [1]. Non-genetic factors include increasing age, high caloric intake, obesity, central adiposity, sedentary lifestyle, and low birth weight. This group comprises approximately 90– 95% of cases in the diabetes syndrome [5]. Chronic hyperglycemia in diabetes leads to various metabolic, hormonal, and physiologic alterations in the body, which further develop a number of secondary complications, which are responsible for major morbidity and mortality [6]. These complications are wide ranging and are grouped into “macrovascular complications” and “microvascular complications.”. While each diabetic complication tends to be considered in isolation, the EU Commission have recently funded a consortium, REDDSTAR, which will focus on the use of mesenchymal stromal cells (MSCs) in the treatment of all microvascular complications of DM
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
