According to recent data from the CDC, an estimated 30 million Americans currently have type 2 diabetes mellitus (T2DM), and another 88 million are considered to be prediabetic[1].
Occurring most often as a result of being overweight and/or sedimentary and often resulting in severe kidney, heart, or vision issues, T2DM has demonstrated to be difficult to treat, often resulting in life-long insulin therapy as the primary method of treatment.
Considering the negative impacts associated with insulin treatment, and T2DM in general, Liu, et al.’s research explores the potential of specific mesenchymal stem cells (MSCs) in the treatment of the condition.
Recently, stem cell therapy has been shown to be beneficial in improving glycemic control and beta function. Building off of these findings, Liu, et. al designed this study to specifically examine the efficacy and safety of Wharton’s Jelly mesenchymal stem cells transplantation (WJ-MSC) as a therapeutic option for those with T2DM.
The authors’ single-center phase I/II study involved observing 22 patients with T2DM for 12 months after receiving two injections of WJ-MSC (one intravenously and one intrapancreatic endovascularly). Over the course of the 12-month observation period, the participants were monitored with primary endpoints observed including changes in the levels of glycated hemoglobin and C-peptide and secondary endpoints including insulin dosage, fasting blood glucose, post-meal blood glucose, inflammatory markers, and T lymphocyte counts.
At the conclusion of this study, Liu et al. found that both glycated hemoglobin and fasting glucose levels demonstrated a progressive decline after WJ-MSC transplantation and over the course of the 12-month follow-up period, the suggested potential of long-lasting effects of the WJ-MSC treatment. Researchers also observed a general improvement in fasting C-peptide levels. Secondary endpoint observations over the course of the 12-month follow-up included improved beta-cell function and reduced markers of systemic inflammation and T lymphocyte counts.
While there were no significant adverse observed effects associated with either of the WJ-MSC injections, the authors did note isolated and separate incidences of mild fever, nausea, and headache in a very small number of participants – all of which spontaneously resolved within a week of onset. The authors also noted a temporary decrease in levels of C-peptide and beta-cell function one month after treatment, possibly related to the intrapancreatic endovascular injection. As a result of these observations, the authors call for further investigation of the safety of intrapancreatic endovascular delivery of WJ-MSC.
As a result of this research, Liu et al. concluded that their findings suggest the possible therapeutic potential of WJ-MSC transplantation for treatment of T2DM and specifically with improved beta-cell function, systemic inflammation, and immunological regulation. The authors also call for further large-scale placebo-controlled clinical studies to fully understand the safety and efficacy of WJ-MSCs in the treatment of T2DM. Source: “PMC – NCBI.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055092/
Perinatal stem cells have been attracting attention globally in recent years due to their potential in regenerative medicine. These stem cells come in many forms, due to the wide variety of potential sources for these cells. Perinatal stem cells, for instance, may be umbilical cord-derived hematopoietic stem cells, amniotic epithelial cells, amniotic fluid stem cells, or chorionic mesenchymal stem cells. All sources, nonetheless are considered biological waste and are therefore usually discarded after delivery of babies.
Importantly, perinatal stem cells, despite their origin, tend to share a number of characteristics that make them beneficial in treating conditions. Additionally, unlike other sources of stem cells, retrieval of perinatal stem cells is noninvasive and does not require the ethical considerations that retrieval from other sources may involve. A recent review in Regenerative Medicine has highlighted the potential benefits of perinatal stem cells in therapeutic interventions.
In addition to the relatively easy collection and preparation of perinatal stem cells, these cells tend to be easily harvested and manipulated without harming either the mother or the baby. Upon collection, these stem cells exist in high volume and have greater ability to proliferate than other stem cell types such as bone marrow stem cells. Research has also shown that these cells tend not to lead to adverse immune reactions, though the mechanisms involved in their relationship to the immune system are not well understood.
Given their relative advantages over other stem cell types, perinatal stem cells are well poised to be used in cell-based therapies targeting a wide variety of conditions. Future research will help to define the precise role these cells can play in regenerative medicine and which conditions they may be most useful for.
Wharton’s jelly is a rather unique body fluid. It is the connective tissue found within the umbilical cord. While Wharton’s jelly is connective tissue, it more closely resembles gelatin. Historically this material was discarded as medical waste; however, Wharton’s jelly has been shown to contain a number of therapeutic substances. Among these healing substances found within Wharton’s jelly is an abundant supply of mesenchymal stem cells.
One of the most intriguing features of Wharton’s jelly is that it contains a virtually limitless supply of mesenchymal stem cells. There are about 4 million new births in the United States each year, 5 million in the European Union, and over 100 million worldwide. The potential pool of cells is staggering when you consider only a small amount of Wharton’s jelly can contain millions of stem cells. Notably, Wharton’s jelly is usually discarded after the delivery of a healthy baby. If this material could be donated instead of discarded, researchers believe they have found an abundant, renewable resource from which to draw mesenchymal stem cells.
However, the abundance of Wharton’s jelly is not the most impressive feature of the substance. The stem cells found in Wharton’s jelly are rather unique. Perhaps most importantly, the cells are immuno-privileged. This means they are not readily recognized by the immune system. Consequently, the stem cells can be taken from the umbilical cord, purified, and then injected into a patient with little risk of the patient having an immune reaction to the cells. These particular mesenchymal stem cells are also interesting because they are relatively “primitive,” which means they have some of the same properties of embryonic stem cells. However, Wharton’s jelly can be obtained without controversy, while harvesting embryonic stem cells from aborted tissue remain highly controversial.
Stem cells taken from Wharton’s jelly are already being used in some clinical studies. For example, researchers in one clinical study injected type 2 diabetes patients with Wharton’s jelly-derived mesenchymal stem cells. Within six months of treatment, 7 of 22 patients became insulin-free and 5 were able to reduce the amount of insulin they needed by more than 50%. Only one patient out of the 22 did not respond to the stem cells at all. The cells have also been tested in systemic lupus erythematosus, better known as simply lupus. Forty patients received Wharton’s jelly mesenchymal stem cells intravenously. Thirteen patients enjoyed a major clinical response while 11 enjoyed a partial clinical response of their lupus symptoms.
As more clinical studies are done on Wharton’s jelly-derived mesenchymal stem cells, we will learn what other diseases can be treated with this once-discarded substance. Early indications show a very promising future.
Mesenchymal stem cells have been showing promise in the treatment of a variety of diseases and injuries. These cells are derived from different tissue types, and it appears that where the stem cells come from is indicative of how they function and how appropriate they are for use in different applications. Bone marrow-derived mesenchymal stem cells have been deeply studied and are often considered a go-to for stem cell research and clinical use.
However, there are several limitations that bone marrow-derived mesenchymal stem cells pose, particularly from a practicality standpoint, and thus, researchers have begun to try to understand how other types of stem cells may achieve similar or better results than those from the bone marrow. A recent review, published in Act Histochemical, compiled comprehensive data on the biological properties associated with a specific type of mesenchymal stem cell called Wharton’s Jelly-derived mesenchymal stem cells.
These stem cells, which come from the umbilical cord, are able to differentiate into mature cells that make up several different types of tissues and can even turn into non-mesenchymal cells, such as neurons, or brain cells. They are useful in that they spontaneously move to sites of injury or inflammation and may, therefore, be able to help restore tissue and normal functioning. They are also unlikely to instigate adverse immune system reactions.
While it is advantageous that bone marrow-derived mesenchymal stem cells have been studied extensively and therefore are associated with broad knowledge of therapeutic applicability, the cells are difficult to isolate and use. In contract, cells from the umbilical cord matrix, or Wharton’s jelly, are easy to isolate and also appear to be good candidates for therapeutic intervention. Future research should therefore look more closely at how Wharton’s jelly-derived mesenchymal stem cells can be used to treat disease and injury. As noted by the authors of this review, there are specifically dysfunctions of the central and peripheral nervous system that these stem cells may be able to address.
Mesenchymal stem cells that come from different cell sources can look similar but behave differently. Bone marrow-derived mesenchymal stem cells tend to be the gold standard for isolating and using mesenchymal stem cells, it is not particularly easy to access these cells from the bone marrow. Because there are other, much more easily accessible mesenchymal stem cells, such as those from the umbilical cord, it is important to establish the differences between the different types of stem cells so that each can be used when most appropriate and when most advantageous.
One important difference is how to isolate the cells and how easy it is to do so. Recent work published this year in Stem Cells and Development helped to define the best way to isolate mesenchymal stem cells from the Wharton’s jelly of umbilical cords. The researchers also looked at the gene expression profile and the immune system characteristics of both bone marrow-derived mesenchymal stem cells and Wharton’s jelly-derived mesenchymal stem cells.
The researchers found that mesenchymal stem cells that came from the Wharton’s jelly of the umbilical cord had a better capacity to expand into more tissue than those taken from the bone marrow. Further, their gene expression was different. In the stem cells from the Wharton’s jelly, there was greater gene enrichment for genes related to cell adhesion, proliferation, and immune system functioning than in the cells from the bone marrow. These cells also induced the maturation of brain cells more so than did the mesenchymal stem cell derived from bone marrow.
These results show that Wharton’s jelly-derived mesenchymal stem cells have distinct properties from bone marrow-derived mesenchymal stem cells and likely have specific advantages as well to help treat those battling osteoarthritis, multiple sclerosis, Parkinson’s disease, and other degenerative conditions. Further research will help bear out more of the differences between these types of stem cells and how each type can best be used to help patients.
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