JooHyun Julie Oh

Type 1 diabetes mellitus (T1DM) is caused by autoimmune destruction of pancreatic islet β cells, which results in loss of insulin production and secretion¹. Approximately 1.25 million Americans have T1DM in the United States and incidence is increasing at a rate of 3-4% every year, notably among children². Current T1DM standard treatment is exogenous insulin administration by administration by either insulin pump or multiple daily injections. These daily insulin therapy does not provide a cure and more problematically may lead to hypoglycemic episodes that can lead to devastating complications of retinopathy, nephropathy, and neuropathy³. Mesenchymal stem cells (MSCs) have been in the spotlight as an innovative approach to T1DM cure because of their multipotency, self-renewal, low immunogenicity and high immunomodulatory properties⁴.  In this paper, we bridge together mechanism with numerous pre-clinical and clinical studies of MSC treatment in T1DM for the readers. In hopes of doing so, we discuss the following: mechanism behind the MSCs immunomodulation that allows it to be an efficient treatment for T1DM, in vivo studies with non-obese diabetic mice that demonstrates successful T1DM treatment from MSC transplantation, study that addresses the limitation of MSC treatment, and clinical trials that suggests well tolerance and immunomodulatory effect of MSC treatment. Significance from these studies points to that Th2 cells confer protection against Th1- mediated destruction of beta cells⁵, MSC transplantation alone can lead to successful treatment for T1DM⁶, even in human populations, and MSC can successfully change T1DM prognosis by delaying disease evolution or even reversing the it⁷.

1. Figliuzzi M, Bonandrini B, Silvani S, Remuzzi A (2014) Mesenchymal stem cells help pancreatic islet transplantation to control type 1 diabetes. World J Stem Cells 6(2):163–172. doi: 10.4252/wjsc.v6.i2.163.
2. VanBuecken D, Lord S, Greenbaum CJ. Changing the Course of Disease in Type 1 Diabetes. [Updated 2015 Jun 29]. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www-ncbi-nlm-nih-gov.ezproxy.library.tamu.edu/books/NBK326738/
3. Chhabra P, Brayman KL (2013) Stem cell therapy to cure type 1 diabetes: from hype to hope. Stem Cells Transl Med 2(5):328–336. doi: 10.5966/sctm.2012
4. Xv J, Ming Q, Wang X, Zhang W, Li Z, Wang S, et al. Mesenchymal stem cells moderate immune response of type 1 diabetes. Cell Tissue Res. 2017; 368:239–48.
5. WANG H, QIU X, NI P, et al. Immunological characteristics of human umbilical cord mesenchymal stem cells and the therapeutic effects of their transplantation on hyperglycemia in diabetic rats. International Journal of Molecular Medicine. 2014;33(2):263-270. doi:10.3892/ijmm.2013.1572.
6. Tsai PJ, Wang HS, Lin GJ, Chou SC, Chu TH, Chuan WT, et al. Undifferentiated Wharton’s jelly mesenchymal stem cell transplantation induces insulin-producing cell differentiation and suppression of T-cell-mediated autoimmunity in non-obese diabetic mice. Cell Transplant. 2015;24(8):1555–70.
7. Mesples A, Majeed N, Zhang Y, Hu X. Early immunotherapy using autologous adult stem cells reversed the effect of anti-pancreatic islets in recently diagnosed type 1 diabetes mellitus: Preliminary results. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2013; 19:852-857. doi:10.12659/MSM.889525.