Diabetes, the "sweet killer" that troubles over 400 million people worldwide, is now facing an unprecedented treatment revolution.

Recently, a review report titled "Research Progress of Mesenchymal Stem Cell Therapy for Diabetes" was published online in the Journal of Naval Medical University. It systematically sorted out the clinical evidence and mechanism of action of mesenchymal stem cells (MSCs) in the field of diabetes treatment in recent years, providing a brand-new idea for the conquest of this stubborn disease.

一、The predicament of traditional therapy: The urgent need to shift from "controlling blood sugar" to "treating blood sugar"

Diabetes is classified into type 1 and Type 2. The former is caused by the immune system attacking pancreatic beta cells, resulting in insufficient insulin secretion, while the latter is triggered by insulin resistance and the decline of beta cell function, leading to uncontrolled blood sugar levels.

Although the current mainstream insulin injections and oral hypoglycemic drugs can control symptoms, they cannot prevent the continuous damage of β cells. Long-term use may also cause side effects such as hypoglycemia and organ atrophy.

What is more serious is that complications of diabetes, such as kidney disease, neuropathy, cardiovascular disease, etc., have become the main causes of disability and death for patients.

二、The "versatile" characteristics of stem cell therapy

Mesenchymal stem cells, these "repair cells" widely present in tissues such as bone marrow, umbilical cord and fat, are rewriting the treatment paradigm of diabetes with their unique biological characteristics:

1. A seed bank for pancreatic islet regeneration

Under specific conditions, MSCs can differentiate into insulin-secreting cells to directly replenish the impaired islet function. Animal experiments have shown that induced MSCs can significantly reduce blood glucose levels in diabetic mice and increase the secretion of C-peptide (a key indicator for measuring pancreatic islet function).

2. The mediator of the immune system

By secreting anti-inflammatory factors (such as IL-10, TGF-β) and inhibiting the excessive activation of T cells, MSCs can effectively curb the autoimmune attack in patients with type 1 diabetes, and at the same time promote the generation of regulatory T cells (Tregs), building a "protective barrier" for pancreatic islet β cells.

3. Remodeler of the metabolic microenvironment

The vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF) secreted by MSCs can not only improve the blood supply to the islets, but also enhance the sensitivity of peripheral tissues to insulin, fundamentally alleviating insulin resistance.

Illustration: Intravenous infusion of mesenchymal stem cells

三、The "Ice-Breaking Journey" of Clinical Data

At present, clinical research on the treatment of diabetes and its complications with mesenchymal stem cells is quite extensive, and multiple studies have proved the effectiveness and safety of the treatment.

The possible mechanisms of mesenchymal stem cell therapy for diabetes include homing effect and improvement of β -cell function, differentiation of mesenchymal stem cells, regeneration and survival of islets, immune regulatory function, and improvement of insulin resistance, etc.

Genetic modification, combined therapy, exosome application, encapsulation technology and other means may help improve the therapeutic effect of mesenchymal stem cells. Multiple clinical trials have confirmed the significant effect of MSCs treatment:

1.Hope for the reversal of type 1 diabetes

In a phase I/II randomized controlled trial, 21 newly diagnosed patients with type 1 diabetes received two infusions of umbilical cord MSCs (1 million cells per kilogram of body weight). One year later, the level of glycated hemoglobin (HbA1c) decreased significantly, the insulin dosage was reduced by nearly 50%, and no serious adverse reactions occurred. Even more encouragingly, the frequency of hypoglycemic attacks in some patients has decreased by more than 80%.

2. The long-lasting efficacy of type 2 diabetes

A study by the General Hospital of the People's Liberation Army shows that after 73 patients with type 2 diabetes received umbilical cord MSCs treatment, 20% achieved HbA1c<7.0% and their insulin dosage was reduced by half within 48 weeks, and 5 patients even completely got rid of insulin dependence.

In the clinical trial of the General Hospital of the Armed Police Force in Beijing, 41% of the patients discontinued insulin within 2 to 6 months, and on average, no further injection was needed for 9.3 months.

3. New breakthroughs in complication management

For diabetic nephropathy, studies have found that MSCs can reduce proteinuria levels by 37% and improve glomerular structure. In the treatment of diabetic neuropathy, the average vibration perception threshold of patients improved by 23%, and the nerve conduction velocity significantly increased.

4. Mechanism Exploration: How Do Stem Cells "Awaken" the Dormant Islets?

The review report reveals the "triple precise regulatory mechanism" by which mesenchymal stem cells (MSCs) function at the molecular level: First of all, MSCs are like a repair team equipped with an intelligent navigation system. They can use chemokines (such as SDF-1, CXCL12 and other chemical signal molecules) released by the damaged pancreas as "navigation signals" to migrate directionally to the injured area of the islets. Just like precisely delivered relief supplies, it locally releases active substances such as vascular endothelial growth factor and hepatocyte growth factor, gradually repairs the tissue microenvironment damaged by inflammation, and rebuilds a "livable home" for pancreatic β cells.

Secondly, on the core battlefield of cellular energy metabolism, MSCs demonstrate the special skills of "mitochondrial engineers" - the latest research has found that they can reverse the mitochondrial signaling pathway, just like re-planning the production line for the cellular energy factory, not only reshaping the maturity of metabolic tissues such as fat and muscle, More direct intervention in the functional state of mitochondria within pancreatic islet β cells can restore efficient energy supply to these "production workshops" responsible for insulin secretion, fundamentally improving the problem of insufficient motivation for insulin secretion.

Furthermore, MSCs also release exosomes carrying "regulatory codes" as "molecular messengers". These nanoscale vesicles enclose specific mirnas (such as miR-29, miR-146, etc.) and protein molecules, acting like secret letters transmitting instructions and directly acting on the key nodes of the insulin signaling pathway. For instance, by activating the AKT/mTOR pathway, it enhances the cell's ability to take up glucose like unblocking a blocked signal pipeline, thus restoring the smoothness of the signal transduction system for blood glucose regulation. These three mechanisms are interlinked, forming a complete therapeutic chain from microenvironment repair to cell function activation, providing a multi-dimensional molecular basis for the pathological reversal of diabetes.

In conclusion, from the laboratory to the clinical setting, mesenchymal stem cells are lighting up hope for diabetic patients with their multi-dimensional therapeutic potential. Although the road ahead still needs to overcome numerous technical and ethical challenges, this medical revolution triggered by stem cells undoubtedly provides a new strategic direction for humanity to overcome chronic diseases. With the advancement of more clinical trials, we have every reason to expect that the day when diabetic patients bid farewell to daily injections and regain a healthy life is no longer far away.