Clinical safety and therapeutic efficacy of autologous bone-marrow derived stem cells in restoring glycemic control and treating complications in diabetic patients

Research Article


Abstract views: 112 / PDF downloads: 49

Authors

  • Jonathan RT Lakey

DOI:

https://doi.org/10.58372/2835-6276.1162

Keywords:

Diabetes, Bone Marrow, Autologous Transplantation, Hematopoietic Stem Cell, Mesenchymal Stem Cell, Bone Marrow-Derived Mononuclear Cells

Abstract

Diabetes is one of the most common chronic diseases worldwide, with around 537 million adults aged 20-79 living with the disease. It is a global epidemic and has a rapidly rising incidence. Traditional treatments for diabetes have limited efficacy in achieving long-term disease control. In recent years, the autologous infusion of bone marrow-derived mononuclear cells (BMMNC) has become a novel and effective therapeutic approach in treating autoimmune type 1 diabetes (T1DM). BMMNC contains two important types of stem cells, bone marrow-derived hematopoietic stem cells (BMHSC) and bone marrow-derived mesenchymal stem cells (BMMSC), which are currently used independently or coordinately in the treatment of T1DM. In this review, we summarize the clinical data concerning BMMNC, BMHSC, and BMMSC infusion in patients with diabetes (including type 1, type 2, and secondary diabetes) and diabetes-related complications. Research suggests that the autologous infusion of bone marrow stem cells is safe and effective, offering the potential to be widely used in patients with diabetes.

References

IDF Diabetes Atlas | Tenth Edition. Accessed January 25, 2023. https://diabetesatlas.org/

National Diabetes Statistics Report | Diabetes | CDC. Accessed December 9, 2022. https://www.cdc.gov/diabetes/data/statistics-report/index.html

Yang W, Dall TM, Beronjia K, et al. Economic costs of diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928. doi:10.2337/DCI18-0007/-/DC1

Gasoyan H, Tajeu G, Halpern MT, Sarwer DB. Reasons for underutilization of bariatric surgery: The role of insurance benefit design. Surg Obes Relat Dis. 2019;15(1):146-151. doi:10.1016/j.soard.2018.10.005

Dholakia S, Royston E, Quiroga I, et al. The rise and potential fall of pancreas transplantation. Br Med Bull. 2017;124(1):171-179. doi:10.1093/BMB/LDX039

Suda S. Bone marrow-derived mononuclear cells. Cell Ther against Cereb Stroke Compr Rev Transl Res Clin Trials. Published online January 1, 2017:3-14. doi:10.1007/978-4-431-56059-3_1

Wehbe T, Chahine NA, Sissi S, Abou-Joaude I, Chalhoub L. Bone marrow derived stem cell therapy for type 2 diabetes mellitus. Stem cell Investig. 2016;3:87. doi:10.21037/SCI.2016.11.14

Bani Hamad FR, Rahat N, Shankar K, Tsouklidis N. Efficacy of Stem Cell Application in Diabetes Mellitus: Promising Future Therapy for Diabetes and Its Complications. Cureus. 2021;13(2):e13563. doi:10.7759/CUREUS.13563

Zhao K, Liu Q. The clinical application of mesenchymal stromal cells in hematopoietic stem cell transplan-tation. J Hematol Oncol. 2016;9(1):46. doi:10.1186/S13045-016-0276-Z

Maqbool S, Nadeem M, Shahroz A, et al. Engraftment syndrome following Hematopoietic stem cell trans-plantation: a systematic approach toward diagnosis and management. Med Oncol. 2022;40(1):36. doi:10.1007/S12032-022-01894-7

Hematopoietic Stem Cell Transplantation - PubMed. StatPearls; 2022. Accessed December 20, 2022. https://pubmed.ncbi.nlm.nih.gov/30725636/

Jawale S. Stem cell therapy for type1 diabetes with transplantation of stem cells into the Omental pouch, peritoneum, and blood, experimental study. Ann Med Surg. 2022;81:104468. doi:10.1016/J.AMSU.2022.104468

Cai J, Wu Z, Xu X, et al. Umbilical Cord Mesenchymal Stromal Cell With Autologous Bone Marrow Cell Transplantation in Established Type 1 Diabetes: A Pilot Randomized Controlled Open-Label Clinical Study to Assess Safety and Impact on Insulin Secretion. Diabetes Care. 2016;39(1):149-157. doi:10.2337/DC15-0171

Mesples A, Majeed N, Zhang Y, Xiang H. Early immunotherapy using autologous adult stem cells reversed the effect of anti-pancreatic islets in recently diagnosed type 1 diabetes mellitus: preliminary results. Med Sci Monit. 2013;19:852-857. doi:10.12659/MSM.889525

Mohamed MT, Embaby EA, Labib A, et al. Effects of exercise in combination with autologous bone marrow stem cell transplantation for patients with type 1 diabetes. Physiother Theory Pract. 2019;35(12):1233-1242. doi:10.1080/09593985.2018.1474511

Thakkar UG, Trivedi HL, Vanikar A V., Dave SD. Insulin-secreting adipose-derived mesenchymal stromal cells with bone marrow-derived hematopoietic stem cells from autologous and allogenic sources for type 1 diabetes mellitus. Cytotherapy. 2015;17(7):940-947. doi:10.1016/J.JCYT.2015.03.608

Alderuccio F, Chan J, Scott DW, Toh BH. Gene therapy and bone marrow stem-cell transfer to treat auto-immune disease. Trends Mol Med. 2009;15(8):344-351. doi:10.1016/J.MOLMED.2009.06.002

Zheng J, Song C, Zhang CC. A new chapter: Hematopoietic stem cells are direct players in immunity. Cell Biosci. 2011;1(1):1-5. doi:10.1186/2045-3701-1-33/FIGURES/1

Voltarelli JC, Couri CEB, Stracieri ABPL, et al. Autologous nonmyeloablative hematopoietic stem cell trans-plantation in newly diagnosed type 1 diabetes mellitus. JAMA. 2007;297(14):1568-1576. doi:10.1001/JAMA.297.14.1568

Snarski E, Milczarczyk A, Torosian T, et al. Independence of exogenous insulin following immunoablation and stem cell reconstitution in newly diagnosed diabetes type I. Bone Marrow Transplant. 2011;46(4):562-566. doi:10.1038/BMT.2010.147

Li L, Shen S, Ouyang J, et al. Autologous hematopoietic stem cell transplantation modulates immunocom-petent cells and improves β-cell function in Chinese patients with new onset of type 1 diabetes. J Clin Endocrinol Metab. 2012;97(5):1729-1736. doi:10.1210/JC.2011-2188

Couri CEB, Oliveira MCB, Stracieri ABPL, et al. C-peptide levels and insulin independence following au-tologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. JAMA. 2009;301(15):1573-1579. doi:10.1001/JAMA.2009.470

Izadi M, Sadr Hashemi Nejad A, Moazenchi M, et al. Mesenchymal stem cell transplantation in newly di-agnosed type-1 diabetes patients: a phase I/II randomized placebo-controlled clinical trial. Stem Cell Res Ther. 2022;13(1):264. doi:10.1186/S13287-022-02941-W

Carlsson PO, Schwarcz E, Korsgren O, Le Blanc K. Preserved β-cell function in type 1 diabetes by mesen-chymal stromal cells. Diabetes. 2015;64(2):587-592. doi:10.2337/DB14-0656

Mesples AD, Cox DCT, Lundy HD, Antonio-Collie S, Diggiss CW, Lakey JRT. Monitoring of Autoantibodies Following Autologous Hematopoietic Stem Cell Transplantation in 6 Children with Recently Diagnosed Type 1 Diabetes Mellitus. Med Sci Monit. 2023;29:e938979. doi:10.12659/MSM.938979

Wang ZX, Cao JX, Li D, et al. Clinical efficacy of autologous stem cell transplantation for the treatment of patients with type 2 diabetes mellitus: a meta-analysis. Cytotherapy. 2015;17(7):956-968. doi:10.1016/J.JCYT.2015.02.014

Bhansali S, Dutta P, Yadav MK, et al. Autologous bone marrow-derived mononuclear cells transplantation in type 2 diabetes mellitus: effect on β-cell function and insulin sensitivity. Diabetol Metab Syndr. 2017;9:50. doi:10.1186/S13098-017-0248-7

Bhansali A, Asokumar P, Walia R, et al. Efficacy and safety of autologous bone marrow-derived stem cell transplantation in patients with type 2 diabetes mellitus: a randomized placebo-controlled study. Cell Transplant. 2014;23(9):1075-1085. doi:10.3727/096368913X665576

Hu J, Li C, Wang L, et al. Long term effects of the implantation of autologous bone marrow mononuclear cells for type 2 diabetes mellitus. Endocr J. 2012;59(11):1031-1039. doi:10.1507/ENDOCRJ.EJ12-0092

Sood V, Bhansali A, Mittal BR, et al. Autologous bone marrow derived stem cell therapy in patients with type 2 diabetes mellitus - defining adequate administration methods. World J Diabetes. 2017;8(7):381-389. doi:10.4239/WJD.V8.I7.381

Wang L, Zhao S, Mao H, Zhou L, Wang ZJ, Wang HX. Autologous bone marrow stem cell transplantation for the treatment of type 2 diabetes mellitus. Chin Med J (Engl). 2011;124(22):3622-3628. doi:10.3760/CMA.J.ISSN.0366-6999.2011.22.005

Estrada EJ, Valacchi F, Nicora E, et al. Combined treatment of intrapancreatic autologous bone marrow stem cells and hyperbaric oxygen in type 2 diabetes mellitus. Cell Transplant. 2008;17(12):1295-1304. doi:10.3727/096368908787648119

Estrada EJ, Decima JL, Bortman G, et al. Combination treatment of autologous bone marrow stem cell transplantation and hyperbaric oxygen therapy for type 2 diabetes mellitus: A randomized controlled trial. Cell Transplant. 2019;28(12):1632-1640. doi:10.1177/0963689719883813

Wu Z, Cai J, Chen J, et al. Autologous bone marrow mononuclear cell infusion and hyperbaric oxygen therapy in type 2 diabetes mellitus: an open-label, randomized controlled clinical trial. Cytotherapy. 2014;16(2):258-265. doi:10.1016/J.JCYT.2013.10.004

Bhansali S, Dutta P, Kumar V, et al. Efficacy of Autologous Bone Marrow-Derived Mesenchymal Stem Cell and Mononuclear Cell Transplantation in Type 2 Diabetes Mellitus: A Randomized, Placebo-Controlled Comparative Study. Stem Cells Dev. 2017;26(7):471-481. doi:10.1089/SCD.2016.0275

Hart PA, Bellin MD, Andersen DK, et al. Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. lancet Gastroenterol Hepatol. 2016;1(3):226-237. doi:10.1016/S2468-1253(16)30106-6

Wang H, Strange C, Nietert PJ, et al. Autologous Mesenchymal Stem Cell and Islet Cotransplantation: Safety and Efficacy. Stem Cells Transl Med. 2018;7(1):11-19. doi:10.1002/SCTM.17-0139

Thakkar U, Vanikar A, Trivedi H. Co-infusion of autologous adipose tissue derived insulin-secreting mes-enchymal stem cells and bone marrow derived hematopoietic stem cells: viable therapy for type III.C. a di-abetes mellitus. Biomed J. 2013;36(6):304-307. doi:10.4103/2319-4170.122898

Wu Z, Xu X, Cai J, et al. Prevention of chronic diabetic complications in type 1 diabetes by co-transplantation of umbilical cord mesenchymal stromal cells and autologous bone marrow: a pilot randomized controlled open-label clinical study with 8-year follow-up. Cytotherapy. 2022;24(4):421-427. doi:10.1016/J.JCYT.2021.09.015

Gaipov A, Taubaldiyeva Z, Askarov M, et al. Infusion of autologous bone marrow derived mononuclear stem cells potentially reduces urinary markers in diabetic nephropathy. J Nephrol. 2019;32(1):65-73. doi:10.1007/S40620-018-0548-5

Siqueira RC, Messias A, Voltarelli JC, Scott IU, Jorge R. Intravitreal injection of autologous bone mar-row-derived mononuclear cells for hereditary retinal dystrophy: a phase I trial. Retina. 2011;31(6):1207-1214. doi:10.1097/IAE.0B013E3181F9C242

Procházka V, Gumulec J, Jalůvka F, et al. Cell therapy, a new standard in management of chronic critical limb ischemia and foot ulcer. Cell Transplant. 2010;19(11):1413-1424. doi:10.3727/096368910X514170

Ruiz-Salmeron R, de la Cuesta-Diaz A, Constantino-Bermejo M, et al. Angiographic demonstration of neo-angiogenesis after intra-arterial infusion of autologous bone marrow mononuclear cells in diabetic patients with critical limb ischemia. Cell Transplant. 2011;20(10):1629-1639. doi:10.3727/096368910X0177

Kirana S, Stratmann B, Prante C, et al. Autologous stem cell therapy in the treatment of limb ischaemia in-duced chronic tissue ulcers of diabetic foot patients. Int J Clin Pract. 2012;66(4):384-393. doi:10.1111/J.1742-1241.2011.02886.X

Dubsky M, Jirkovska A, Bem R, et al. Both autologous bone marrow mononuclear cell and peripheral blood progenitor cell therapies similarly improve ischaemia in patients with diabetic foot in comparison with con-trol treatment. Diabetes Metab Res Rev. 2013;29(5):369-376. doi:10.1002/DMRR.2399

Gu X, Yu X, Zhao C, et al. Efficacy and Safety of Autologous Bone Marrow Mesenchymal Stem Cell Trans-plantation in Patients with Diabetic Retinopathy. Cell Physiol Biochem. 2018;49(1):40-52. doi:10.1159/000492838

Al Demour S, Jafar H, Adwan S, et al. Safety and Potential Therapeutic Effect of Two Intracavernous Au-tologous Bone Marrow Derived Mesenchymal Stem Cells injections in Diabetic Patients with Erectile Dys-function: An Open Label Phase I Clinical Trial. Urol Int. 2018;101(3):358-365. doi:10.1159/000492120

Dash NR, Dash SN, Routray P, Mohapatra S, Mohapatra PC. Targeting nonhealing ulcers of lower extremity in human through autologous bone marrow-derived mesenchymal stem cells. Rejuvenation Res. 2009;12(5):359-366. doi:10.1089/REJ.2009.0872

Lu D, Jiang Y, Deng W, et al. Long-Term Outcomes of BMMSC Compared with BMMNC for Treatment of Critical Limb Ischemia and Foot Ulcer in Patients with Diabetes. Cell Transplant. 2019;28(5):645-652. doi:10.1177/0963689719835177

Lu D, Chen B, Liang Z, et al. Comparison of bone marrow mesenchymal stem cells with bone mar-row-derived mononuclear cells for treatment of diabetic critical limb ischemia and foot ulcer: a double-blind, randomized, controlled trial. Diabetes Res Clin Pract. 2011;92(1):26-36. doi:10.1016/J.DIABRES.2010.12.010

Chen Y, Ma Y, Li N, et al. Efficacy and long-term longitudinal follow-up of bone marrow mesenchymal cell transplantation therapy in a diabetic patient with recurrent lower limb bullosis diabeticorum. Stem Cell Res Ther. 2018;9(1):99. doi:10.1186/S13287-018-0854-9

Van De Vyver M. Intrinsic Mesenchymal Stem Cell Dysfunction in Diabetes Mellitus: Implications for Au-tologous Cell Therapy. Stem Cells Dev. 2017;26(14):1042-1053. doi:10.1089/SCD.2017.0025

Nguyen LT, Hoang DM, Nguyen KT, et al. Type 2 diabetes mellitus duration and obesity alter the efficacy of autologously transplanted bone marrow-derived mesenchymal stem/stromal cells. Stem Cells Transl Med. 2021;10(9):1266-1278. doi:10.1002/SCTM.20-0506

Downloads

Published

2024-04-30

How to Cite

Jonathan RT Lakey. (2024). Clinical safety and therapeutic efficacy of autologous bone-marrow derived stem cells in restoring glycemic control and treating complications in diabetic patients: Research Article. American Journal of Medical and Clinical Research & Reviews, 3(4), 1–10. https://doi.org/10.58372/2835-6276.1162

Issue

Section

Articles