Abstract
Diabetes mellitus is one of the most severe endocrine metabolic disorders in the world that has serious medical consequences with substantial impacts on the quality of life. Type 2 diabetes is one of the main causes of diabetic liver diseases with the most common being non-alcoholic fatty liver disease. Several factors that may explain the mechanisms related to pathological and functional changes of diabetic liver injury include: insulin resistance, oxidative stress and endoplasmic reticulum stress. The realization that these factors are important in hepatocyte damage and lack of donor livers has led to studies concentrating on the role of stem cells (SCs) in the prevention and treatment of liver injury. Possible avenues that the application of SCs may improve liver injury include but are not limited to: the ability to differentiate into pancreatic β-cells (insulin producing cells), the contribution for hepatocyte regeneration, regulation of lipogenesis, glucogenesis and anti-inflammatory actions. Once further studies are performed to explore the underlying protective mechanisms of SCs and the advantages and disadvantages of its application, there will be a greater understand of the mechanism and therapeutic potential. In this review, we summarize the findings regarding the role of SCs in diabetic liver diseases.
Highlights
Pathological features of diabetic liver injury Mechanisms involved in the development of diabetic liver injury– Insulin resistance with diabetic liver injury – Oxidative stress with diabetic liver injury – Endoplasmic reticulum stress and diabetic liver injury– Other mechanisms related to diabetic liver injury Categorizations of stem cells Stem cells and diabetes Stem cells in diabetic liver injury Limitations and issues of stem cell treatment Conclusion AbstractDiabetes mellitus is one of the most severe endocrine metabolic disorders in the world that has serious medical consequences with substantial impacts on the quality of life
The mechanisms underlying the curative effect of stem cells (SCs) on diabetic liver injury may include the following: SCs reduce hyperglycaemia and alleviate liver damage; they directly differentiate into islet beta cells or hepatocytes under certain conditions; they induce endogenous SCs to regenerate, such as promoting hepatic oval cells (HOCs) to differentiate into fully functional mature hepatic cells; they adjust the immune response, lipogenesis and relieve Insulin resistance (IR) and they may exert an anti-apoptotic effect and prevent liver fibrosis
Most research has been focused on mesenchymal stem cells (MSCs) and their impact on diabetic liver
Summary
The number of patients with diabetes mellitus (DM) is increasing exponentially [1]. Diabetes is estimated to be the most common cause of liver diseases [2, 3], which has, in turn, become a major cause of death [4]. Studies demonstrated that ERS is involved in the pathogenesis of several liver diseases including NAFLD, liver cirrhosis and viral hepatitis [37, 38] This response plays an important role to exacerbate lipid metabolic disorder and contributes to steatohepatitis in diabetes [39]. Other researchers have shown that MSC therapy reversed hepatic injury in high fat diet (HFD)-induced diabetic mice by suppressing pro-inflammatory cytokine expression in the liver. Mesenchymal stem cell and MSC-CM therapies ameliorated IR and the homoeostasis model assessment-estimated IR was down-regulated in HFD-diabetic mice [53] Another mechanism of hepatocyte repair observed in MSC and MSC-CM therapy includes reduction in lipid accumulation and inhibiting expression of pro-inflammatory cytokines in diabetic liver injury. The inhibition of pro-inflammatory cytokines leads to decreased activation of c-Jun amino-terminal kinase and p38 mitogen-activated
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