Jayasinghe Maleesha, Prathiraja Omesh, Perera Prashan B, Jena Rahul, Silva Minollie Suzanne, Weerawarna P S H, Singhal Malay, Kayani Abdul Mueez Alam, Karnakoti Snigdha, Jain Samiksha
Medicine, Nanjing Medical University, Galle, LKA.
Medicine and Surgery, Nanjing Medical University, Melbourne, AUS.
Cureus. 2022 Jul 27;14(7):e27337. doi: 10.7759/cureus.27337. eCollection 2022 Jul.
Type 1 diabetes (T1D) is a chronic disease characterized by inadequate or absent insulin production due to the autoimmune destruction of beta (β) cells in the pancreas. It was once called "juvenile diabetes" since the disease frequently occurs in children, but it can also develop in adults. According to the International Diabetes Federation, an estimated 700 million adults will suffer from diabetes by 2045. Although the exact cause of diabetes remains unknown, it is hypothesized that genetic factors, environmental factors, and exposure to certain viruses play a role in the development of T1D. To date, exogenous insulin is the most common treatment for T1D. However, it is not a cure for the disease. Islet cell transplantation and pancreatic transplantation are two additional treatments that have gained popularity in recent years, but their clinical application may be limited by the need for high doses of immunosuppressants, the rarity of human cadaveric islets, and the need for extensive surgery in pancreatic transplantation. Mesenchymal stem cells (MSCs) are a highly promising novel treatment for T1D and their discovery has advanced biological sciences by allowing for modification of cell fate and the development of higher-order cellular structures. They play an essential role in lowering levels of fasting blood sugar, hemoglobin A1c, and C-peptide, and in treating microvascular complications associated with T1D. However, some of the disadvantages of its use in clinical practice are limited to its method of collection, proliferation rate, cell activity with age, and the risk of tumour formation identified in some studies. Large-scale studies are required to discover the mechanism of action of MSCs after administration as well as the optimal route, dose, and timing to maximize the benefits to patients. This article focuses primarily on the role of MSCs in the treatment of T1D and compares the feasibility, benefits, and drawbacks of MSCs in the treatment of T1D.
1型糖尿病(T1D)是一种慢性疾病,其特征是由于胰腺中β细胞的自身免疫性破坏导致胰岛素分泌不足或缺乏。它曾被称为“青少年糖尿病”,因为这种疾病经常在儿童中发生,但也可能在成年人中发展。根据国际糖尿病联合会的数据,到2045年估计将有7亿成年人患有糖尿病。尽管糖尿病的确切病因仍然未知,但据推测,遗传因素、环境因素以及接触某些病毒在T1D的发展中起作用。迄今为止,外源性胰岛素是T1D最常见的治疗方法。然而,它并不能治愈该疾病。胰岛细胞移植和胰腺移植是近年来受到关注的另外两种治疗方法,但它们的临床应用可能受到高剂量免疫抑制剂的需求、人类尸体胰岛的稀缺性以及胰腺移植中广泛手术需求的限制。间充质干细胞(MSCs)是一种极有前景的T1D新型治疗方法,它们的发现通过允许细胞命运的改变和高阶细胞结构的发展推动了生物科学的进步。它们在降低空腹血糖、糖化血红蛋白A1c和C肽水平以及治疗与T1D相关的微血管并发症方面发挥着重要作用。然而,其在临床实践中使用的一些缺点包括采集方法有限、增殖率、细胞活性随年龄变化以及一些研究中发现的肿瘤形成风险。需要进行大规模研究以发现MSCs给药后的作用机制以及最佳途径、剂量和时间,以最大限度地为患者带来益处。本文主要关注MSCs在T1D治疗中的作用,并比较MSCs在T1D治疗中的可行性、益处和缺点。