4.7 Article

Mesenchymal stem cell transplantation in newly diagnosed type-1 diabetes patients: a phase I/II randomized placebo-controlled clinical trial

Journal

STEM CELL RESEARCH & THERAPY
Volume 13, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s13287-022-02941-w

Keywords

Type 1 diabetes; Mesenchymal stem cells; Cell therapy; Immunomodulation; Randomized controlled trial; Regulatory T cells

Funding

  1. Royan Institute [94000019]
  2. Iranian Vice-Presidency for Science and Technology, Council for Development of Stem Cell Sciences and Technologies [REP-441]

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This study evaluated the safety and efficacy of autologous bone marrow-derived mesenchymal stem cells (MSCs) transplantation via intravenous injection in newly diagnosed type-1 diabetes (T1D) patients. The results showed that MSCs transplantation is safe, reduces hypoglycemic episodes, improves glycemic control and immune function, and enhances quality of life in T1D patients.
Background: Type-1 diabetes (T1D) occurs following autoimmune-induced pancreatic beta cells death. Among several treatment modalities, mesenchymal stem cells (MSCs) transplantation is promising for autoimmune disorders due to immunomodulation, regeneration, and migration to damaged tissue upon systemic injection. This study assessed the safety and efficacy of intravenous injection of autologous bone marrow-derived MSCs in newly diagnosed T1D patients. Methods: After receiving informed consent, 21 patients who met the study criteria were enrolled and randomly assigned to receive either MSCs or placebo. Each patient in the experimental group received two doses of MSCs and was followed for at least one-year post-transplantation. Results: The results have shown that this transplantation is safe and significantly reduces the number of hypoglycemic episodes. MSCs transplantation improved glycated hemoglobin (HbA1c), shifted serum cytokine patterns from pro-inflammatory to anti-inflammatory, increased the number of regulatory T-cells in the peripheral blood, and improved quality of life. Early transplantation of MSCs significantly improved HbA1c and C-peptide levels and shifted pro-inflammatory cytokines to anti-inflammatory cytokines. Also, exercise combined with MSCs transplantation improved glycemic and immunologic indices. Conclusions: Taken together, autologous MSC transplantation is safe and effective, and its early transplantation is a promising treatment in newly diagnosed T1D children suffering from hypoglycemic episodes.

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