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Effectiveness and safety of human umbilical cord-mesenchymal stem cells for treating type 2 diabetes mellitus

医学 脐带 胰岛素抵抗 内科学 小岛 糖尿病 不利影响 2型糖尿病 葡萄糖稳态 2型糖尿病 血红蛋白 内分泌学 胰岛素 间充质干细胞 胃肠病学 病理 免疫学
作者
Xiao-Fen Lian,Dong-Hui Lu,Hongli Liu,Yan‐Jing Liu,Xiu-Qun Han,Yang� Yang,Yuan Lin,Qingxiang Zeng,Zhengjie Huang,Feng Xie,Cai-Hao Huang,Hongmei Wu,Ai-Mei Long,Ling-Ping Deng,Fan Zhang
出处
期刊:World Journal of Diabetes [Baishideng Publishing Group Co (World Journal of Diabetes)]
卷期号:13 (10): 877-887 被引量:15
标识
DOI:10.4239/wjd.v13.i10.877
摘要

Progressive pancreatic β-cell dysfunction is a fundamental part of the pathology of type 2 diabetes mellitus (T2DM). Cellular therapies offer novel opportunities for the treatment of T2DM to improve the function of islet β-cells.To evaluate the effectiveness and safety of human umbilical cord-mesenchymal stem cell (hUC-MSC) infusion in T2DM treatment.Sixteen patients were enrolled and received 1 × 106 cells/kg per week for 3 wk as intravenous hUC-MSC infusion. The effectiveness was evaluated by assessing fasting blood glucose, C-peptide, normal glycosylated hemoglobin A1c (HbA1c), insulin resistance index (homeostatic model assessment for insulin resistance), and islet β-cell function (homeostasis model assessment of β-cell function). The dosage of hypoglycemic agents and safety were evaluated by monitoring the occurrence of any adverse events (AEs).During the entire intervention period, the fasting plasma glucose level was significantly reduced [baseline: 9.3400 (8.3575, 11.7725), day 14 ± 3: 6.5200 (5.2200, 8.6900); P < 0.01]. The HbA1c level was significantly reduced on day 84 ± 3 [baseline: 7.8000 (7.5250, 8.6750), day 84 ± 3: 7.150 (6.600, 7.925); P < 0.01]. The patients' islet β-cell function was significantly improved on day 28 ± 3 of intervention [baseline: 29.90 (16.43, 37.40), day 28 ± 3: 40.97 (19.27, 56.36); P < 0.01]. The dosage of hypoglycemic agents was reduced in all patients, of whom 6 (50%) had a decrement of more than 50% and 1 (6.25%) discontinued the hypoglycemic agents. Four patients had transient fever, which occurred within 24 h after the second or third infusion. One patient (2.08%) had asymptomatic nocturnal hypoglycemia after infusion on day 28 ± 3. No liver damage or other side effects were reported.The results of this study suggest that hUC-MSC infusion can improve glycemia, restore islet β-cell function, and reduce the dosage of hypoglycemic agents without serious AEs. Thus, hUC-MSC infusion may be a novel option for the treatment of T2DM.
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