Management of Type 1 diabetes mellitus with autologous mesenchymal stem cells

Abstract

Type 1 diabetes mellitus (DM) is one of the most common chronic metabolic disorders among children. The condition is associated with dysregulation of the immune system resulting in loss of self-tolerance and destruction of pancreatic β-cells by autoreactive T-lymphocytes. Regulation of β-cell homeostasis is vital to maintain optimum blood glucose control as well as prevent the development of complications. Exogenous insulin and oral hypoglycemic agents do not achieve this, as they do not address the core pathology of type 1 DM. This report describes a case of a 17-year-old female patient with fluctuating blood glucose levels and high glycosylated hemoglobin, unresponsive to conventional therapy. After undergoing two sessions of cell-based therapy, within a year, optimum control of blood glucose was achieved along with negative anti-insulin antibodies. The patient was able to discontinue insulin and has not experienced any adverse effects till date. Improvement in general health was noticed, and the patient is now free from any symptoms associated with her former diabetic status. Mesenchymal stem cells (MSCs) possess immunomodulatory and pro-angiogenic properties, which may aid in arresting β-cell destruction. In addition, MSCs may preserve residual β-cell mass and facilitate endogenous β-cell regeneration. These cells are capable of differentiating into glucose-responsive insulin-producing cells, making them ideal candidates in treatment of and prevention of complications in T1DM.

Keywords

• Immunomodulation
• mesenchymal stem cells
• type 1 diabetes