• Mesenchymal Stem Cells in the Treatment of Type 1 Diabetes Mellitus
  • Artemis Azad Aza,1,* Elena Ebrahimian,2 Masoud Homayouni Tabrizi ,3
    1. Department of Biology, Faculty of Basic Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
    2. Department of Biology, Faculty of Basic Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
    3. Department of Biology, Ma.C., Islamic Azad University, Mashhad, Iran


  • Introduction: The irreversible loss of the insulin-secreting β cells in the pancreas is a hallmark of type 1 diabetes mellitus (T1DM), a chronic, multifactorial autoimmune disease. ultimately results in the reduction of insulin synthesis and secretion. Insufficient insulin synthesis prevents cells from absorbing glucose, resulting in persistent hyperglycemia. It mostly affects young people, accounting for 85% of cases in those under 20 and 5% to 10% of all diagnosed cases of diabetes. Restoring normoglycemia and maintaining long-term glycemic control are two important advantages of pancreatic transplantation. Islet transplantation, which was created using the Ricordi Method, offers a less invasive option that focuses on replacing islet cells with a high yield and purity. However, it has drawbacks such a long waiting list, immunosuppressive drug side effects, and a shortage of donor material. to accomplish the two main objectives of type 1 diabetes, which are to reverse autoimmunity and enhance natural insulin production. Progenitor cell differentiation or stem cell therapy-induced cell self-replication can accomplish this. Because of their capacity to regulate the immune system, their capacity to develop into cells that produce insulin in lab conditions, and the absence of ethical issues, mesenchymal stem cells (MSCs) are an especially alluring choice. The main biological characteristics of MSCs will be discussed in the review that follows, along with an assessment of how well they work as therapeutic therapies for type 1 diabetes.
  • Methods: Using the PubMed, Web of Science, Scopus, and Google Scholar databases, we performed a thorough literature search for this review. We used a mix of terms and phrases, such as autoimmunity, insulin production, mesenchymal stem cells, and type 1 diabetes mellitus. This strategy guaranteed a thorough review of the current literature and developments in the use of MSCs to the treatment of type 1 diabetes.
  • Results: MSC Differentiation into Insulin-Producing Cells (IPCs) in Vitro MSCs can become IPCs with the use of specialized culture media supplemented with nicotinamide and glucose. IPC identification requires the expression of genes associated with pancreatic development, such as insulin, GLUT2, and PDX1, which demonstrate functional abilities like insulin synthesis. MSCs Derived from Bone Marrow (BM-MSCs) Rat BM-MSCs can produce IPCs when grown in high-glucose or nicotinamide-enriched media, and these cells can regulate glucose levels in animal models of diabetes. Using a specific 18-day protocol, BM-MSCs from patients with Type 1 and Type 2 diabetes have successfully differentiated into IPCs in human trials, displaying similar morphology and increased pancreatic gene expression. ADSCs, or adipose-derived stem cells These stem cells are derived from human adipose tissue and have the same capacity for differentiation as BM-MSCs. Studies have indicated that ADSCs have notable pancreatic gene expressions and may be created more realistically than BM-MSCs. MSCs from umbilical cord blood (UCB-MSCs) MSCs that can develop into IPCs are seen in UCB; these cells exhibit important pancreatic markers and respond to glucose by producing insulin and C-peptide. MSCs in the pancreas Some evidence suggests that pancreatic duct cells may act as progenitor cells that give rise to new islets. Research indicates that pancreatic MSCs have the potential to differentiate into insulin-producing functional cells under some situations. MSC-Based Treatment in Autoimmune Diabetes Animal Models NOD and NOD/SCID mice are often used models for studying type 1 diabetes because they are exactly like human autoimmune diabetes. MSCs generated from bone marrow and umbilical cords have both been shown to improve hyperglycemia and boost insulin production in diabetic mice, indicating that MSC therapy may be useful in both situations. These preclinical studies provide valuable new insights into the potential of MSC-based therapies for type 1 diabetes in clinical settings.
  • Conclusion: In conclusion, MSCs' capacity to develop into cells that produce insulin and regulate autoimmune reactions makes them extremely promising for the treatment of type 1 diabetic mellitus (T1DM). Ongoing research into MSC-based therapeutics may open the door to novel ways to enhance glycemic control and restore insulin production in T1DM patients, despite obstacles including donor availability and immunosuppressive medicines.
  • Keywords: Diabetes Mellitus, Mesenchymal Stem Cells