Bebé Vida, Ciências para a Vida, S.A; Av. da França 476, 4050-367, Porto, Portugal.
Ciências Químicas e das Biomoléculas, Escola Superior de Saúde do Porto, Porto, Portugal.
Cell Tissue Res. 2021 Sep;385(3):497-518. doi: 10.1007/s00441-021-03461-4. Epub 2021 May 29.
The umbilical cord has been proved to be an easy-access, reliable, and useful source of mesenchymal stem cells (MSC) for clinical applications due to its primitive, immunomodulatory, non-immunogenic, secretory and paracrine, migratory, proliferative, and multipotent properties. This set of characteristics has recently attracted great research interest in the fields of nanotechnology and regenerative medicine and cellular therapy. Accumulating evidence supports a pronounced therapeutic potential of MSC in many different pathologies, from hematology to immunology, wound-healing, tissue regeneration, and oncology. Diabetes mellitus, branded the epidemic of the century, is considered a chronic metabolic disorder, representing a major burden for health system sustainability and an important public health challenge to modern societies. The available treatments for type 2 diabetes mellitus (T2DM) still rely mainly on combinations of oral antidiabetic agents with lifestyle and nutritional adjustments. Despite the continuous development of novel and better hypoglycemic drugs, their efficacy is limited in the installment and progression of silent T2DM complications. T2DM comorbidities and mortality rates still make it a serious, common, costly, and long-term manageable disease. Recently, experimental models, preclinical observations, and clinical studies have provided some insights and preliminary promising results using umbilical cord MSCs to treat and manage diabetes. This review focuses on the latest research and applications of human-derived umbilical cord MSC in the treatment and management of T2DM, exploring and systematizing the key effects of both umbilical cord MSC and its factor-rich secretome accordingly with the major complications associated to T2DM.
脐带已被证明是一种易于获取、可靠且有用的间充质干细胞(MSC)来源,可用于临床应用,因其具有原始、免疫调节、非免疫原性、分泌和旁分泌、迁移、增殖和多能性等特性。这些特性最近引起了纳米技术和再生医学及细胞治疗领域的极大研究兴趣。越来越多的证据支持 MSC 在许多不同的病理中具有显著的治疗潜力,从血液学到免疫学、伤口愈合、组织再生和肿瘤学。糖尿病被称为世纪流行病,被认为是一种慢性代谢紊乱,代表着医疗系统可持续性的主要负担,也是现代社会面临的一个重要公共卫生挑战。目前,2 型糖尿病(T2DM)的治疗方法仍主要依赖于口服降糖药物与生活方式和营养调整的联合治疗。尽管新型和更好的降血糖药物不断发展,但它们的疗效在 T2DM 并发症的分期和进展方面受到限制。T2DM 的合并症和死亡率仍然使其成为一种严重、常见、昂贵且长期可控的疾病。最近,实验模型、临床前观察和临床研究为使用脐带 MSC 治疗和管理糖尿病提供了一些见解和初步有希望的结果。本综述重点介绍了人类来源的脐带 MSC 在治疗和管理 T2DM 中的最新研究和应用,探索和系统地分析了脐带 MSC 及其富含因子的分泌组在治疗 T2DM 相关主要并发症方面的关键作用。