Stem Cell as a Novel Therapy for Diabetic Cardiomyopathy

Abstract

Islets transplantation has o ameliorate t recently been shownhyperglycemia In Diabetes Mellitus (DM) [1]; however the usage of this therapy has been restrained due to the limited supply of human islets tissue and the associated use of immune suppression to prevent graft rejection [2]. The employment of renewable supply of stem cells capable of differentiation into useful islet secreting cells is among the substitutions for islet cell transplantation. The open journal of endocrinology and metabolic syndrome and OMICS conferences have recently given a considerable distinction within the field of medical specialty to extend the depth of material on endocrine diseases and emphasize the metabolic syndrome as a predisposing factor for the development of diabetes. Diabetes Mellitus (DM), one among the leading causes of morbidity and mortality in several countries, is instigated either by absolute insulin deficiency because of destruction of the pancreatic insulin secreting cells (DMT1) or by relative hormone deficiency due to the decrease in hormone sensitivity (DMT2). In bot h types, the insufficient functional islet cell mass would determine the onset of symptoms and the development of obvious diabetes [1]. Diabetic cardiomyopathy has been defined as the development of ventricular dysfunction in the absence of coronary artery diseases, valvular heart disease, or hypertension in diabetic patients (DCM) [3]. It has also been seen that dominant features within the advancement of DCM are chronic hyperglycemia and increased oxidative stress [4,5].Mesenchymal Stem Cells (MSCs)are considered enticing as therapeutic agents for variety of diseases as well as diabetes due to their ability to differentiate into many cells. MSCs were found to induce myogenesis through release of different angiogenic, mitogenic, and antiapoptotic factors as well as Vascular Epithelium Protein (VEGF) and insulin-like growth factor-1 (IGF-1). Differentiation of MSCs into cardiomyocytes improved cardiac function in DCM rat model [6]. The release of MSC-derived paracrine factors capable of cardio protection has proven to lead to improvement of cardiac function following MSCs therapy [7]. It has been previously suggested that these factors have an effect on remodeling, regeneration, and neo vascularization resulting in enhancement of myocardium contractility and amelioration of infarction [8]. Our work indicates that rat bone marrow-derived MSCs have the capability to differentiate into insulin-producing cells that represents a cell-based treatment for DM. We additionally proved that MSCs transplantation improved cardiac function in streptozotocin- induced diabetic rats [9]. Moreover, Oh et al. [10] showed that that in a particular in-vitro culture condition MSCs derived from bone marrow can be transformed into islet cells with restoration of blood glucose level back to control level in diabetic animal model. Based on the mentioned findings, questions are raised to match the effectiveness of differentiated versus undifferentiated MSCs in treatment of diabetic cardiovascular complications. Hence, we extended our work (Unpublished data) where we proved that infusion of either undifferentiated or differentiated MSCs ameliorated diabetic cardiovascular complications. It has also been proven that among the central obstacles for efficient therapeutic use of MSCs are poor engraftment and restricted differentiation. The frequency of spontaneous differentiation of MSCs within the host tissue is rare; therefore, therapeutic use of MSCs depends on the ability to control their in vivo differentiation into committed cells with high potency and purity [11]. A further drawback is the potential of MSCs to differentiate into unwanted mesenchymal lineages [12] that might impair their therapeutic use. Additional possible limitations are malignant transformation and cytogenetic aberrations of MSCs [11].