The Role of Stem Cells in the Treatment of Type 1 Diabetes Mellitus and Associated Complications

Abstract

Type 1 diabetes (T1D) affects many individuals worldwide and is associated with multiple long-term complications. The underlying pathophysiology of T1D involves an autoimmune process that leads to destruction of pancreatic β-islet cells, which are the sole cells responsible for producing the body’s insulin. Thus, the current recommended treatment for T1D is insulin therapy, which requires continuous awareness and monitoring throughout the day, placing a great deal of stress and responsibility on patients. Various modalities are under investigation to provide alternatives to treatment, or even a cure. Adult endogenous progenitor cells have been studied as one potential therapy for patients with T1D due to their ability to prevent an allogenic immune response in addition to an autoimmune response. Additionally, pancreatic ductal cells and bone marrow stem cells served as one of the first areas of research that demonstrated self-progenitor cells could regenerate pancreatic islet cells. A major limitation to stem cell therapy success is the risk of graft rejection. However, altering immune cell composition and creating physical barriers to protect the implanted cells from attack has been one successful solution to this by circumventing the pernicious immune response that is characteristic of T1D. Other limitations of these therapies include teratoma risk and the inability to reproduce the required signaling environment for cell differentiation ex vivo. Furthermore, stem cell therapy has shown promise in its applications for treatment of diabetes-associated complications including diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. This article critically reviews previous research and current progress toward stem cell treatment options for patients with T1D.