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沃顿胶间充质干细胞移植治疗2型糖尿病患者的疗效和安全性的初步评估。

A preliminary evaluation of efficacy and safety of Wharton's jelly mesenchymal stem cell transplantation in patients with type 2 diabetes mellitus.

作者信息

Liu Xuebin, Zheng Pei, Wang Xiaodong, Dai Guanghui, Cheng Hongbin, Zhang Zan, Hua Rongrong, Niu Xinxin, Shi Jing, An Yihua

出版信息

Stem Cell Res Ther. 2014 Apr 23;5(2):57. doi: 10.1186/scrt446.

Abstract

INTRODUCTION

Stem cell therapy has recently been introduced to treat patients with type 2 diabetes mellitus (T2DM). However, no data are available on the efficacy and safety of allogeneic Wharton's Jelly-derived mesenchymal stem cell (WJ-MSC) transplantation in patients with T2DM. Here we performed a non-placebo controlled prospective phase I/II study to determine efficacy and safety of WJ-MSC transplantation in T2DM.

METHODS

Twenty-two patients with T2DM were enrolled and received WJ-MSC transplantation through one intravenous injection and one intrapancreatic endovascular injection (catheterization). They were followed up for 12 months after transplantation. The primary endpoints were changes in the levels of glycated hemoglobin and C-peptide and the secondary endpoints included insulin dosage, fasting blood glucose (FBG), post-meal blood glucose (PBG), inflammatory markers and T lymphocyte counts.

RESULTS

WJ-MSC transplantation significantly decreased the levels of glucose and glycated hemoglobin, improved C-peptide levels and beta cell function, and reduced markers of systemic inflammation and T lymphocyte counts. No major WJ-MSC transplantation-related adverse events occurred, but data suggest a temporary decrease in levels of C-peptide and beta cell function at one month after treatment, possibly related to intrapancreatic endovascular injection.

CONCLUSIONS

Our data demonstrate that treatment with WJ-MSCs can improve metabolic control and beta cell function in patients with T2DM. The therapeutic mechanism may involve improvements in systemic inflammation and/or immunological regulation.

TRIAL REGISTRATION

Chinese Clinical Trial Register ChiCTR-ONC-10000985. Registered 23 September 2010.

摘要

引言

干细胞疗法最近被用于治疗2型糖尿病(T2DM)患者。然而,关于同种异体脐带华通氏胶间充质干细胞(WJ-MSC)移植治疗T2DM患者的疗效和安全性尚无数据。在此,我们进行了一项非安慰剂对照的前瞻性I/II期研究,以确定WJ-MSC移植治疗T2DM的疗效和安全性。

方法

招募22例T2DM患者,通过一次静脉注射和一次胰腺内血管内注射(导管插入术)接受WJ-MSC移植。移植后对他们进行12个月的随访。主要终点是糖化血红蛋白和C肽水平的变化,次要终点包括胰岛素剂量、空腹血糖(FBG)、餐后血糖(PBG)、炎症标志物和T淋巴细胞计数。

结果

WJ-MSC移植显著降低了血糖和糖化血红蛋白水平,改善了C肽水平和β细胞功能,并降低了全身炎症标志物和T淋巴细胞计数。未发生与WJ-MSC移植相关的重大不良事件,但数据表明治疗后1个月C肽水平和β细胞功能暂时下降,可能与胰腺内血管内注射有关。

结论

我们的数据表明,WJ-MSCs治疗可改善T2DM患者的代谢控制和β细胞功能。治疗机制可能涉及全身炎症和/或免疫调节的改善。

试验注册

中国临床试验注册中心ChiCTR-ONC-10000985。2010年9月23日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850f/4055092/dbd5919e8758/scrt446-1.jpg

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