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糖尿病患者的干细胞治疗:基于代谢组学的风险与益处的系统评价和荟萃分析

Stem cell therapy for patients with diabetes: a systematic review and meta-analysis of metabolomics-based risks and benefits.

作者信息

Rahim Fakher, Arjmand Babak, Shirbandi Kiarash, Payab Moloud, Larijani Bagher

机构信息

Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Stem Cell Investig. 2018 Nov 14;5:40. doi: 10.21037/sci.2018.11.01. eCollection 2018.

Abstract

BACKGROUND

There is a general agreement that to ensure promising results of stem cell therapy in patients with diabetes, one must first understand its risks and benefits; thus, if the risk is sufficiently low along with many benefits, it can lead to developing a novel therapeutic approach based on sound science.

METHODS

A systematic review and meta-analysis was performed using all available clinical trials to determine the benefits and risks associated with stem cell therapy in patients with diabetes (both T1DM and T2DM). An extensive search was conducted across several databases using all MeSH words regarding stem cell therapy and diabetes.

RESULTS

In T2DM, a large body of research has shown that stem cell therapy has improved the insulin daily requirement and glycosylated hemoglobin (HbA1C) levels, and also has a positive effect on these variables, but has a negative impact on c-peptide. Hence, in T1DM, stem cell therapy improves c-peptide and HbA1C levels and has a positive effect on these variables, but has a negative impact on insulin daily requirement.

CONCLUSIONS

A total of 639 cells have the ability to self-renew and differentiate into a variety of cells, including blood, heart, nervous and cartilage cells. Paradoxically, it has been stated that these cells also have the potential to form cancer cells. These possible risks warrant caution by both medical specialists and patients while proceeding with the treatment; thus, it is critically crucial to conduct further research on stem cell therapy but with first considering their risk and benefits.

摘要

背景

人们普遍认为,为确保干细胞疗法在糖尿病患者中取得良好效果,必须首先了解其风险和益处;因此,如果风险足够低且益处众多,就可以基于可靠的科学发展出一种新的治疗方法。

方法

通过对所有可用的临床试验进行系统评价和荟萃分析,以确定干细胞疗法在糖尿病患者(1型糖尿病和2型糖尿病)中的益处和风险。使用所有与干细胞疗法和糖尿病相关的医学主题词在多个数据库中进行了广泛检索。

结果

在2型糖尿病中,大量研究表明干细胞疗法改善了每日胰岛素需求量和糖化血红蛋白(HbA1C)水平,并且对这些变量也有积极影响,但对C肽有负面影响。因此,在1型糖尿病中,干细胞疗法改善了C肽和HbA1C水平,并且对这些变量有积极影响,但对每日胰岛素需求量有负面影响。

结论

共有639种细胞具有自我更新和分化为多种细胞的能力,包括血液、心脏、神经和软骨细胞。矛盾的是,有人指出这些细胞也有可能形成癌细胞。在进行治疗时,这些潜在风险需要医学专家和患者谨慎对待;因此,在首先考虑干细胞疗法的风险和益处的同时,对其进行进一步研究至关重要。

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