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间质干细胞移植治疗 1 型糖尿病:当前进展与未来机遇。

Mesenchymal Stem Cell Transplantation in Type 1 Diabetes Treatment: Current Advances and Future Opportunity.

机构信息

Department of Endocrinology, Third Xiangya Hospital, Central South University, Changsha, 410013, China.

Clinical Medicine Eight-year Program, 19 Grade, Xiangya School of Medicine, Central South University, Changsha, 410013, China.

出版信息

Curr Stem Cell Res Ther. 2024;19(9):1175-1184. doi: 10.2174/011574888X268740231002054459.

Abstract

Type 1 Diabetes (T1D) is characterized by hyperglycemia, and caused by a lack of insulin secretion. At present there is no cure for T1D and patients are dependent on exogenous insulin for lifelong, which seriously affects their lives. Mesenchymal stem cells (MSCs) can be differentiated to β cell-like cells to rescue the secretion of insulin and reconstruct immunotolerance to preserve the function of islet β cells. Due to the higher proportion of children and adolescents in T1D patients, the efficacy and safety issue of the application of MSC's transplant in T1D was primarily demonstrated and identified by human clinical trials in this review. Then we clarified the mechanism of MSCs to relieve the symptom of T1D and found out that UC-MSCs have no obvious advantage over the other types of MSCs, the autologous MSCs from BM or menstrual blood with less expanded ex vivo could be the better choice for clinical application to treat with T1D through documentary analysis. Finally, we summarized the advances of MSCs with different interventions such as genetic engineering in the treatment of T1D, and demonstrated the advantages and shortage of MSCs intervened by different treatments in the transplantation, which may enhance the clinical efficacy and overcome the shortcomings in the application of MSCs to T1D in future.

摘要

1 型糖尿病(T1D)的特征是高血糖,由胰岛素分泌不足引起。目前尚无治愈 T1D 的方法,患者需要终生依赖外源性胰岛素,这严重影响了他们的生活。间充质干细胞(MSCs)可分化为β细胞样细胞,以挽救胰岛素的分泌并重建免疫耐受,从而保护胰岛β细胞的功能。由于 T1D 患者中儿童和青少年的比例较高,因此本综述主要通过人类临床试验证明和确定了 MSC 移植在 T1D 中的应用的疗效和安全性问题。然后,我们阐明了 MSCs 缓解 T1D 症状的机制,发现 UC-MSCs 并没有明显优于其他类型的 MSCs,通过文献分析,来自 BM 或月经血的自体 MSCs 体外扩增较少,可能是治疗 T1D 的临床应用的更好选择。最后,我们总结了不同干预措施(如基因工程)下的 MSCs 在 T1D 治疗中的进展,并展示了不同治疗方法干预的 MSCs 在移植中的优缺点,这可能会提高临床疗效,并在未来克服 MSCs 应用于 T1D 的不足。

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