Bone Marrow-Derived Stem Cells: a Mixed Blessing in the Multifaceted World of Diabetic Complications

Abstract

Diabetes is one of the main economic burdens in health care, which threatens to worsen dramatically if prevalence forecasts are correct. What makes diabetes harmful is the multi-organ distribution of its microvascular and macrovascular complications. Regenerative medicine with cellular therapy could be the dam against life-threatening or life-altering complications. Bone marrow-derived stem cells are putative candidates to achieve this goal. Unfortunately, the bone marrow itself is affected by diabetes, as it can develop a microangiopathy and neuropathy similar to other body tissues. Neuropathy leads to impaired stem cell mobilization from marrow, the so-called mobilopathy. Here, we review the role of bone marrow-derived stem cells in diabetes: how they are affected by compromised bone marrow integrity, how they contribute to other diabetic complications, and how they can be used as a treatment for these. Eventually, we suggest new tactics to optimize stem cell therapy.

Keywords: Bone marrow; Cell regenerative therapy; Diabetes; Diabetic complications; Microangiopathy; Stem cells.

Fig. 1

Mechanisms responsible for bone marrow remodeling under chronic hyperglycemia and oxidative stress and potential therapeutic applications. The orange box represents early pathobiological events which trigger later ones, shown in the yellow boxes. Possible therapeutic applications are shown in the green boxes