Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland.
J Clin Endocrinol Metab. 2023 Jul 14;108(8):1889-1897. doi: 10.1210/clinem/dgad142.
The worldwide increase in the prevalence of diabetes mellitus has raised the demand for new therapeutic strategies targeting diabetic symptoms and its chronic complications. Among different treatment options for diabetes, adipose-derived mesenchymal stem cells (ADMSCs) therapy attract the most attention. The therapeutic effects of ADMSCs are based primarily on their paracrine release of immunomodulatory, anti-inflammatory, and trophic factors. Animal models of diabetes as well as human clinical trials have shown that ADMSCs can effectively facilitate endogenous β cell regeneration, preserve residual β cell mass, reduce islet graft rejection, regulate the immune system, and ultimately improve insulin sensitivity or ameliorate insulin resistance in peripheral tissues. Nevertheless, transplantation of mesenchymal stem cells is associated with certain risks; therefore recently much attention has been devoted to ADMSCs derivatives, such as exosomes or conditioned media, as therapeutic agents for the treatment of diabetes. Compared to ADMSCs, cell-free therapy has even better therapeutic potential. This narrative review summarizes recent outcomes and molecular mechanisms of ADMSCs action in the treatment for both type 1 DM and type 2 DM, as well as shows their feasibility, benefits, and current limitations.
全球范围内糖尿病患病率的增加,提高了针对糖尿病症状及其慢性并发症的新治疗策略的需求。在糖尿病的不同治疗选择中,脂肪来源的间充质干细胞(ADMSCs)治疗最受关注。ADMSCs 的治疗效果主要基于其旁分泌释放的免疫调节、抗炎和营养因子。糖尿病动物模型以及人类临床试验表明,ADMSCs 可以有效促进内源性β细胞再生、保留残余β细胞量、减少胰岛移植物排斥、调节免疫系统,从而最终改善外周组织的胰岛素敏感性或减轻胰岛素抵抗。然而,间充质干细胞的移植存在一定风险;因此,最近人们越来越关注 ADMSCs 的衍生物,如外泌体或条件培养基,作为治疗糖尿病的治疗药物。与 ADMSCs 相比,无细胞治疗具有更好的治疗潜力。本文综述总结了 ADMSCs 在治疗 1 型和 2 型糖尿病中的作用的最新结果和分子机制,并展示了它们的可行性、益处和当前的局限性。