Type 2 diabetes patients who are not overweight and who have had the disease for less than a decade can benefit from stroma stem cells transplanted from their own bone marrow (“Type 2 Diabetes Mellitus Duration and Obesity Age the Efficacy of Autologously Auto). Transplanted Bone Marrow-derived Mesenchymal Stem / Stromal Cells ”) published in Stem Cells Translational Medicine.
In a randomized clinical trial at the Vinmec Research Institute of Stem Cell and Gene Technology in Hanoi, Vietnam, researchers investigated the safety and potential therapeutic value of administering bone marrow stromal stem cells to patients with type 2 diabetes. In each case the cells were autologous or taken from the patient’s own body.
A total of 30 adult patients with different body mass indices, whose history of type 2 diabetes varied between one and 25 years, were recruited for the study. Each received two infusions of the cells intravenously or by injection into an artery that supplies blood to the pancreas.
The researchers monitored the patients for 48 hours and re-examined them at intervals of one month, three months, six months, and one year. The treatment did not reveal any significant health problems for the patients, and they appeared to benefit equally from either method of infusion.
“Human bone marrow-derived mesenchymal stem / stromal cells (BM-MSCs) represent a promising stem cell therapy for the treatment of type 2 diabetes mellitus (T2DM), but the results of autologous BM-MSC administration in T2DM patients are inconsistent. The purpose of this study was to test the hypothesis that autologous BM-MSC administration is safe in T2DM patients and that treatment effectiveness depends on the quality of the autologous BM-MSC population and routes of administration, ”they write Researcher.
“T2DM patients were enrolled at random (1: 1) through a computerized system into the intravenous and dorsal pancreatic artery group. Safety was assessed in all treated patients and efficacy was assessed by the absolute changes in hemoglobin A1c, fasting blood sugar, and C-peptide levels during the 12 month follow-up. Our data showed that autologous BM-MSC administration was well tolerated in 30 T2DM patients. Short-term therapeutic effects were observed in patients with a T2DM duration of <10 years and a body mass index <23, which is consistent with the phenotypic analysis of the autologous BM-MSC population. The T2DM duration directly altered the rate of proliferation of BM-MSCs, abolished glycolysis and mitochondrial respiration of BM-MSCs, and induced the accumulation of mitochondrial DNA mutations.
“Our data suggest that autologous administration of BM-MSCs should be used in the treatment of T2DM in patients with T2DM duration <10 years and without obesity. Before the effects of T2DM on BM-MSC biology can be further confirmed, future work with a larger cohort focusing on patients with diverse T2DM histories is needed to understand the mechanism underlying our observation. "
“Our patients tolerated the procedure well and showed a short-term decrease in their blood sugar levels after treatment,” said Liem Nguyen, MD, PhD, research director of the institute. “We also found that some of them were able to temporarily reduce the dosage of their diabetes medication.”
About 420 million people worldwide have type 2 diabetes, a condition that accounts for around 90 percent of all diabetes cases and often leads to disability or death. People with type 2 diabetes cannot make good use of the insulin their bodies make. Increased physical activity and a healthy diet can improve the condition in some people, but many need to take insulin or medication to control their blood sugar levels.
The patients in the Vinmec study were divided into three groups based on the diabetes medications they had regularly taken prior to their stem cell infusions. Some kept their blood sugar levels up using only insulin. Others took medication but not insulin, and still others took a combination of insulin and medication.
After treatment, more than half of the patients were able to lower the dose of their diabetes medication.
“Our study, the first to link the results of an autologous bone marrow stroma stem cell transplant to body mass index and duration of type 2 diabetes, shows that the procedure is safe and opens the way for other clinical trials who are investigating the potential benefit of this treatment in non-patient-obese patients who have had the condition for less than 10 years, “said Nguyen.
Bone marrow stromal stem cells, also called mesenchymal stem cells, play a key role in the body’s immune response and can transform into connective tissue cells in any organ. Over the past 50 years they have developed into a versatile cell source in the field of regenerative medicine.
“The results of this randomized clinical trial for patients with type 2 diabetes and having their own stromal stem cells injected from the bone marrow are encouraging and may add to the treatment arsenal for this chronic disease that affects so many worldwide,” said Anthony Atala, MD, editor-in-chief of Stem Cells Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine. “Of particular interest is the short-term effectiveness in patients with type 2 diabetes with a history of less than 10 years and a bone mass index of less than 23. This work opens up opportunities for future research to further investigate this field.”
