Concise review: Mesenchymal stem cell treatment of the complications of diabetes mellitus

Abstract

Mesenchymal stem cells (MSCs) are multipotent, self-renewing cells that can be found in almost all postnatal organs and tissues. The main functional characteristics of MSCs are their immunomodulatory ability, capacity for self-renewal, and differentiation into mesodermal tissues. The ability of MSCs to differentiate into several cell types, including muscle, brain, vascular, skin, cartilage, and bone cells, makes them attractive as therapeutic agents for a number of diseases including complications of diabetes mellitus. We review here the potential of MSCs as new therapeutic agents in the treatment of diabetic cardiomyopathy, diabetic nephropathy, diabetic polyneuropathy, diabetic retinopathy, and diabetic wounds. Also, in this review we discuss the current limitations for MSCs therapy in humans.

Figure 1

Effects of transplanted MSCs on diabetic cardiomyopathy. (a) MSCs increase the activity of MMP-2 and decrease the activity of MMP-9 and attenuate cardiac remodeling. (b) MSCs produce VEGF, IGF-1, AM, HGF and stimulate myogenesis and angiogenesis in damaged myocardium. (c) Through differentiation into cardiomyocytes and vascular endothelial cells, MSCs improve myocardial perfusion and myocardium regeneration. Abbreviations: AM, adrenomedullin; HGF, hepatocyte growth factor; IGF-1, insulin-like growth factor-1; MMP, matrix metalloproteinase; MSC, mesenchymal stem cell; VEGF, vascular endothelial growth factor.

Figure 2

Effects of MSCs treatment on diabetic polyneuropathy. Four weeks after intramuscular injection, MSCs settled in the gap between muscle fibers, through production of bFGF and VEGF, induces neovascularization and support regeneration of neural cells that results with improvement of diabetic polyneuropathy. Abbreviations: bFGF, basic fibroblast growth factor; MSC, mesenchymal stem cell; VEGF, vascular endothelial growth factor.