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Li N, Hu L, Li J, Ye Y, Bao Z, Xu Z, Chen D, Tang J, Gu Y. The Immunomodulatory effect of exosomes in diabetes: a novel and attractive therapeutic tool in diabetes therapy. Front Immunol 2024; 15:1357378. [PMID: 38720885 PMCID: PMC11076721 DOI: 10.3389/fimmu.2024.1357378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/03/2024] [Indexed: 05/12/2024] Open
Abstract
Exosomes carry proteins, metabolites, nucleic acids and lipids from their parent cell of origin. They are derived from cells through exocytosis, are ingested by target cells, and can transfer biological signals between local or distant cells. Therefore, exosomes are often modified in reaction to pathological processes, including infection, cancer, cardiovascular diseases and in response to metabolic perturbations such as obesity and diabetes, all of which involve a significant inflammatory aspect. Here, we discuss how immune cell-derived exosomes origin from neutrophils, T lymphocytes, macrophages impact on the immune reprogramming of diabetes and the associated complications. Besides, exosomes derived from stem cells and their immunomodulatory properties and anti-inflammation effect in diabetes are also reviewed. Moreover, As an important addition to previous reviews, we describes promising directions involving engineered exosomes as well as current challenges of clinical applications in diabetic therapy. Further research on exosomes will explore their potential in translational medicine and provide new avenues for the development of effective clinical diagnostics and therapeutic strategies for immunoregulation of diabetes.
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Affiliation(s)
- Na Li
- Research Institute for Reproductive Health and Genetic Diseases, Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu, China
| | - Lingli Hu
- Graduate School of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jingyang Li
- Graduate School of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yang Ye
- Research Institute for Reproductive Health and Genetic Diseases, Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu, China
| | - Zhengyang Bao
- Research Institute for Reproductive Health and Genetic Diseases, Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu, China
| | - Zhice Xu
- Research Institute for Reproductive Health and Genetic Diseases, Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu, China
| | - Daozhen Chen
- Research Institute for Reproductive Health and Genetic Diseases, Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu, China
| | - Jiaqi Tang
- Institute for Fetology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ying Gu
- Research Institute for Reproductive Health and Genetic Diseases, Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu, China
- Department of Obstetrics, Wuxi Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China
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2
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Zhao Y, Knight CM, Jiang Z, Delgado E, Van Hoven AM, Ghanny S, Zhou Z, Zhou H, Yu H, Hu W, Li H, Li X, Perez-Basterrechea M, Zhao L, Zhao Y, Giangola J, Weinberg R, Mazzone T. Stem Cell Educator therapy in type 1 diabetes: From the bench to clinical trials. Clin Exp Rheumatol 2022; 21:103058. [PMID: 35108619 DOI: 10.1016/j.autrev.2022.103058] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/25/2022] [Indexed: 12/11/2022]
Abstract
Type 1 diabetes (T1D) is an autoimmune disease that causes a deficit of pancreatic islet β cells. Millions of individuals worldwide have T1D, and its incidence increases annually. Recent clinical trials have highlighted the limits of conventional immunotherapy in T1D and underscore the need for novel treatments that not only overcome multiple immune dysfunctions, but also help restore islet β-cell function. To address these two key issues, we have developed a unique and novel procedure designated the Stem Cell Educator therapy, based on the immune education by cord-blood-derived multipotent stem cells (CB-SC). Over the last 10 years, this technology has been evaluated through international multi-center clinical studies, which have demonstrated its clinical safety and efficacy in T1D and other autoimmune diseases. Mechanistic studies revealed that Educator therapy could fundamentally correct the autoimmunity and induce immune tolerance through multiple molecular and cellular mechanisms such as the expression of a master transcription factor autoimmune regulator (AIRE) in CB-SC for T-cell modulation, an expression of Galectin-9 on CB-SC to suppress activated B cells, and secretion of CB-SC-derived exosomes to polarize human blood monocytes/macrophages into type 2 macrophages. Educator therapy is the leading immunotherapy to date to safely and efficiently correct autoimmunity and restore β cell function in T1D patients.
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Affiliation(s)
- Yong Zhao
- Throne Biotechnologies, Paramus, NJ 07652, USA.
| | - Colette M Knight
- Hackensack Meridian School of Medicine, Inserra Family Diabetes Institute, Department of Medicine, Hackensack University Medical Center, Hackensack, NJ 07601, USA.
| | - Zhaoshun Jiang
- Department of Endocrinology, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, Shandong 250031, China.
| | - Elias Delgado
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias (HUCA), Department of Medicine, University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo 33006, Spain.
| | - Anne Marie Van Hoven
- Hackensack Meridian School of Medicine, Inserra Family Diabetes Institute, Department of Medicine, Hackensack University Medical Center, Hackensack, NJ 07601, USA
| | - Steven Ghanny
- Department of Pediatric, Division of Endocrinology and Diabetes, Hackensack University Medical Center, Hackensack, NJ 07601, USA
| | - Zhiguang Zhou
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Huimin Zhou
- Section of Endocrinology, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, China
| | - Haibo Yu
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Wei Hu
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, USA
| | - Heng Li
- Section of Neurology, Jinan Central Hospital, Shandong University, Jinan, Shandong 250020, China
| | - Xia Li
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Marcos Perez-Basterrechea
- Unit of Cell Therapy and Regenerative Medicine, Hematology and Hemotherapy, Central University Hospital of Asturias, Health Research Institute of the Principality of Asturias (ISPA), Oviedo 33006, Spain
| | - Laura Zhao
- Throne Biotechnologies, Paramus, NJ 07652, USA
| | - Yeqian Zhao
- Throne Biotechnologies, Paramus, NJ 07652, USA
| | - Joseph Giangola
- Hackensack Meridian School of Medicine, Inserra Family Diabetes Institute, Department of Medicine, Hackensack University Medical Center, Hackensack, NJ 07601, USA
| | - Rona Weinberg
- MPN Laboratory, New York Blood Center, New York, NY 10065, USA
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Escobar-Soto CH, Mejia-Romero R, Aguilera N, Alzate-Granados JP, Mendoza-Pinto C, Munguía-Realpozo P, Méndez-Martínez S, García-Carrasco M, Rojas-Villarraga A. Human mesenchymal stem cells for the management of systemic sclerosis. Systematic review. Autoimmun Rev 2021; 20:102831. [PMID: 33878487 DOI: 10.1016/j.autrev.2021.102831] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/11/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Sistemic Sclerosis (SSc) is a heterogeneous autoimmune disease with a high rate of progression and therapeutic failure, and treatment is a challenge, new therapeutic proposals being needed, being mesenchymal stem cells (MSCs) considered as alternative therapy for SSc for its immunomodulatory capacity. We evaluated the efficacy and safety of human MSC (hMSC) in patients with SSc through a systematic literature review (SLR). METHODS SLR (PRISMA guideline) on MEDLINE/OVID, LILACS, EMBASE, and Cochrane/OVID bases (until July 2020, without limits). All types of clinical studies were considered: patients ≥18 years old with SSc and treatment with hMSC. EXCLUSION CRITERIA animal models, autologous/allogenic hematopoietic stem cell transplants, narrative reviews, letters to the editor. MeSH and "Key word" terms were used. The level of evidence and the quality rating were rated [Joanna Briggs Institute (JBI) lists]. Registration in PROSPERO repository (ID CRD42020185245) The Synthesis Without Meta-analysis (SWiM) guideline was followed. RESULTS We initially identified 508 articles, of which 11 were finally included (8 case series and 3 case reports). The 11 articles included 101 patients (85 female, age range 18-75 years). The level of evidence was mostly 4 (JBI); the quality of evidence was met (≥50% of JBI items). SWiM showed that vascular skin involvement (digital ulcers, necrosis, and gangrene) and associated pain were the predominant outcomes, while improvements were found in almost all cases. One patient died in the first month, and the frequency of complications was low. Expanded hMSCs were used in 24 patients and other cell sources in the remaining patients. CONCLUSION There is too little reported data to reach definite conclusions about the use of hMSC in SSc. Further studies with better epidemiological designs are needed to evaluate the benefit of hMSCs in SSc patients.
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Affiliation(s)
| | | | - Natalia Aguilera
- Research Division, Fundación Universitaria de Ciencias de la Salud, University of Health Sciences, Bogotá, Colombia
| | - Juan Pablo Alzate-Granados
- Research Division, Fundación Universitaria de Ciencias de la Salud, University of Health Sciences, Bogotá, Colombia
| | - Claudia Mendoza-Pinto
- Systemic Autoimmune Disease Research Unit, UMAE-CIBIOR, Instituto Mexicano del Seguro Social, Puebla, Mexico; Rheumatology Department, Medicine School, Benemerita Universidad Autonoma de Puebla, Puebla, Mexico
| | - Pamela Munguía-Realpozo
- Rheumatology Department, Medicine School, Benemerita Universidad Autonoma de Puebla, Puebla, Mexico
| | - Socorro Méndez-Martínez
- Coordinator of Planning and Institutional Liaison, Instituto Mexicano del Seguro Social Puebla, Mexico
| | - Mario García-Carrasco
- Systemic Autoimmune Disease Research Unit, UMAE-CIBIOR, Instituto Mexicano del Seguro Social, Puebla, Mexico; Rheumatology Department, Medicine School, Benemerita Universidad Autonoma de Puebla, Puebla, Mexico.
| | - Adriana Rojas-Villarraga
- Research Institute, Fundación Universitaria De Ciencias De La Salud, University of Health Sciences, Bogota, Colombia
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Effect of Adipose Tissue-Derived Stem Cell Transplantation and Six Weeks of Aerobic Exercise on FNDC5 and Irisin Levels in Streptozotocin-Induced Diabetic Rats. MEDICAL LABORATORY JOURNAL 2020. [DOI: 10.52547/mlj.14.6.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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5
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Generation of Hematopoietic-Like Stem Cells from Adult Human Peripheral Blood Following Treatment with Platelet-Derived Mitochondria. Int J Mol Sci 2020; 21:ijms21124249. [PMID: 32549211 PMCID: PMC7352808 DOI: 10.3390/ijms21124249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/06/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023] Open
Abstract
Adult stem cells represent a potential source for cellular therapy to treat serious human diseases. We characterized the insulin-producing cells from adult peripheral blood (designated PB-IPC), which displayed a unique phenotype. Mitochondria are normally located in the cellular cytoplasm, where they generate ATP to power the cell’s functions. Ex vivo and in vivo functional studies established that treatment with platelet-derived mitochondria can reprogram the transformation of adult PB-IPC into functional CD34+ hematopoietic stem cells (HSC)-like cells, leading to the production of blood cells such as T cells, B cells, monocytes/macrophages, granulocytes, red blood cells, and megakaryocytes (MKs)/platelets. These findings revealed a novel function of mitochondria in directly contributing to cellular reprogramming, thus overcoming the limitations and safety concerns of using conventional technologies to reprogram embryonic stem (ES) and induced pluripotent stem (iPS) cells in regenerative medicine.
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Hu W, Song X, Yu H, Sun J, Zhao Y. Released Exosomes Contribute to the Immune Modulation of Cord Blood-Derived Stem Cells. Front Immunol 2020; 11:165. [PMID: 32161585 PMCID: PMC7052489 DOI: 10.3389/fimmu.2020.00165] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 01/21/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Clinical studies demonstrated the immune modulation of cord blood-derived stem cells (CB-SC) for the treatment of type 1 diabetes and other autoimmune diseases, with long-lasting clinical efficacy. To determine the molecular mechanisms underlying the immune modulation of CB-SC, the actions of exosomes released from CB-SC were explored in this study. Methods: Exosomes were isolated from CB-SC cultures using ultracentrifugation and confirmed with different markers. The activated T cells and purified monocytes from peripheral blood mononuclear cells (PBMC) were treated with CB-SC in the presence or absence of the purified exosomes, followed by functional and flow cytometry analysis of phenotypic changes with different immune cell markers. Results: CB-SC-derived exosomes displayed the exosome-specific markers including CD9, CD63, and Alix, at the size of 85.95 ± 22.57 nm. In comparison with the treatment of CB-SC, functional analysis demonstrated that the CB-SC-derived exosomes inhibited the proliferation of activated PBMC, reduced the production of inflammatory cytokines, downregulated the percentage of activated CD4+ T and CD8+ T cells, and increased the percentage of naive CD4+ T and CD8+ T cells. Using the fluorescence dye DiO-labeled exosomes, flow cytometry revealed that exosomes preferably bound to the monocytes in the PBMC, leading to an improvement of mitochondrial membrane potential of treated monocytes. Further study indicated that the purified monocytes gave rise to spindle-like macrophages displaying type 2 macrophage (M2) surface markers and upregulating an expression of immune tolerance-related cytokines after the treatment with exosomes. Conclusions: CB-SC-derived exosomes display multiple immune modulations and primarily on monocytes, contributing to the immune education of CB-SC in the clinical treatment of autoimmune diseases.
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Affiliation(s)
- Wei Hu
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States.,Department of Chemistry and Chemistry Biology, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Xiang Song
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Haibo Yu
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Jingyu Sun
- Department of Chemistry and Chemistry Biology, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Yong Zhao
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
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Investigating the route of administration and efficacy of adipose tissue-derived mesenchymal stem cells and conditioned medium in type 1 diabetic mice. Inflammopharmacology 2019; 28:585-601. [PMID: 31741175 DOI: 10.1007/s10787-019-00661-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/29/2019] [Indexed: 12/11/2022]
Abstract
Type 1 diabetes (T1D) is a chronic autoimmune disease destroying the insulin-producing beta cells. Recently, stem cell therapy has been tested to treat T1D. In the present study, we aim to investigate the effects of intraperitoneal and intravenous infusion of multipotent mesenchymal stem/stromal cells (MSCs) and MSC-conditioned medium (MSC-CM) in an experimental model of diabetes, induced by multiple injections of Streptozotocin (STZ). The adipose tissue-derived MSC and MSC-CM were isolated from C57Bl/6 male mice and characterized. Later, MSC and MSC-CM were injected intraperitoneally or intravenously into mice. The blood glucose, urinary glucose, and body weight were measured, and the percentages of CD4+ CD25+ FOXP3+ T cells as well as the levels of IFN-γ, TGF-β, IL-4, IL-17, and IL-10 were evaluated. Our results showed that both intraperitoneal and intravenous infusions of MSC and MSC-CM could decrease the blood glucose, recover pancreatic islets, and increase the levels of insulin-producing cells. Furthermore, the percentage of CD4+ CD25+ FOXP3+ T cells was increased after intraperitoneal injection of MSC or MSC-CM and intravenous injection of MSCs. After intraperitoneal injection of the MSC and MSC-CM, the levels of inflammatory cytokines reduced, while the levels of anti-inflammatory cytokines increased. Together current data showed that although both intraperitoneal and intravenous administration had beneficial effects on T1D animal model, but intraperitoneal injection of AD-MSC and AD-MSC-CM was more effective than systemic administration.
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8
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Stiner R, Alexander M, Liu G, Liao W, Liu Y, Yu J, Pone EJ, Zhao W, Lakey JRT. Transplantation of stem cells from umbilical cord blood as therapy for type I diabetes. Cell Tissue Res 2019; 378:155-162. [PMID: 31209568 DOI: 10.1007/s00441-019-03046-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 04/21/2019] [Indexed: 12/15/2022]
Abstract
In recent years, human umbilical cord blood has emerged as a rich source of stem, stromal and immune cells for cell-based therapy. Among the stem cells from umbilical cord blood, CD45+ multipotent stem cells and CD90+ mesenchymal stem cells have the potential to treat type I diabetes mellitus (T1DM), to correct autoimmune dysfunction and replenish β-cell numbers and function. In this review, we compare the general characteristics of umbilical cord blood-derived multipotent stem cells (UCB-SCs) and umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) and introduce their applications in T1DM. Although there are some differences in surface marker expression between UCB-SCs and UCB-MSCs, the two cell types display similar functions such as suppressing function of stimulated lymphocytes and imparting differentiation potential to insulin-producing cells (IPCs) in the setting of low immunogenicity, thereby providing a promising and safe approach for T1DM therapy.
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Affiliation(s)
- Rachel Stiner
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA.,Department of Surgery, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, 92868, USA
| | - Michael Alexander
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA.,Department of Surgery, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, 92868, USA.,Department of Biomedical Engineering, University of California, Irvine, 402 E Peltason Dr, Irvine, CA, 92697, USA
| | - Guangyang Liu
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA.,Department of Surgery, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, 92868, USA.,Department of Biomedical Engineering, University of California, Irvine, 402 E Peltason Dr, Irvine, CA, 92697, USA.,Baylx, Inc., 23 Spectrum Pointe Dr Suite 207, Lake Forest, CA, 92630, USA
| | - Wenbin Liao
- Baylx, Inc., 23 Spectrum Pointe Dr Suite 207, Lake Forest, CA, 92630, USA
| | - Yongjun Liu
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA.,Department of Biomedical Engineering, University of California, Irvine, 402 E Peltason Dr, Irvine, CA, 92697, USA.,Baylx, Inc., 23 Spectrum Pointe Dr Suite 207, Lake Forest, CA, 92630, USA.,Department of Pharmaceutical Sciences, University of California, Irvine, 147 Bison Modular, Irvine, CA, 92697, USA
| | - Jingxia Yu
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA.,Department of Surgery, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, 92868, USA.,Department of Biomedical Engineering, University of California, Irvine, 402 E Peltason Dr, Irvine, CA, 92697, USA.,Baylx, Inc., 23 Spectrum Pointe Dr Suite 207, Lake Forest, CA, 92630, USA
| | - Egest J Pone
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA.,Department of Biomedical Engineering, University of California, Irvine, 402 E Peltason Dr, Irvine, CA, 92697, USA.,Department of Pharmaceutical Sciences, University of California, Irvine, 147 Bison Modular, Irvine, CA, 92697, USA.,Chao Family Comprehensive Cancer Center, University of California, Irvine, 101 The City Dr S, Orange, CA, 92868, USA.,Department of Biological Chemistry, University of California, Irvine, Irvine, CA, 92697, USA
| | - Weian Zhao
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA.,Department of Biomedical Engineering, University of California, Irvine, 402 E Peltason Dr, Irvine, CA, 92697, USA.,Baylx, Inc., 23 Spectrum Pointe Dr Suite 207, Lake Forest, CA, 92630, USA.,Department of Pharmaceutical Sciences, University of California, Irvine, 147 Bison Modular, Irvine, CA, 92697, USA.,Chao Family Comprehensive Cancer Center, University of California, Irvine, 101 The City Dr S, Orange, CA, 92868, USA.,Department of Biological Chemistry, University of California, Irvine, Irvine, CA, 92697, USA
| | - Jonathan R T Lakey
- Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, 845 Health Sciences Road, Irvine, CA, 92697, USA. .,Department of Surgery, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, 92868, USA. .,Department of Biomedical Engineering, University of California, Irvine, 402 E Peltason Dr, Irvine, CA, 92697, USA. .,Baylx, Inc., 23 Spectrum Pointe Dr Suite 207, Lake Forest, CA, 92630, USA.
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Zhong JX, Chen J, Rao X, Duan L. Dichotomous roles of co-stimulatory molecules in diabetes mellitus. Oncotarget 2018; 9:2902-2911. [PMID: 29416823 PMCID: PMC5788691 DOI: 10.18632/oncotarget.23102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 11/15/2017] [Indexed: 11/25/2022] Open
Abstract
Numerous studies have established the importance of immune dysfunction in the development of diabetes mellitus, including typ1 and typ2 diabetes, and it is worth noting that T cell activation acts a key role in the pathogenesis of loss of β cell mass, adipose inflammation and insulin resistance. Regarding as an important checkpoint in the process of T cell activation, co-stimulatory molecules interaction between antigen present cells and T cells have been identified the critical role in the development of diabetes mellitus. Thus, blockage of co-stimulatory dyads interaction between antigen present cells and T cells was supposed to a potential of therapeutic strategies. However, studies also showed that inhibition or deletion of some co-stimulatory molecules do not always reduce the development of diabetes, and even exacerbate the disease activity. Here, in this context, we highlight the dichotomous role of co-stimulatory molecules interaction in the pathogenesis of diabetes.
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Affiliation(s)
- Ji-Xin Zhong
- Department of Endocrinology, Central Hospital of Wuhan, Wuhan, Hubei, China 430061
| | - Jie Chen
- Cardiovascular Research Institute, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA 44106
- Basic Medical Department of Medical College, Xiamen University, Xiamen, China 361102
| | - Xiaoquan Rao
- Cardiovascular Research Institute, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA 44106
| | - Lihua Duan
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China 361003
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10
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Zhao Y, Jiang Z, Delgado E, Li H, Zhou H, Hu W, Perez-Basterrechea M, Janostakova A, Tan Q, Wang J, Mao M, Yin Z, Zhang Y, Li Y, Li Q, Zhou J, Li Y, Martinez Revuelta E, Maria García-Gala J, Wang H, Perez-Lopez S, Alvarez-Viejo M, Menendez E, Moss T, Guindi E, Otero J. Platelet-Derived Mitochondria Display Embryonic Stem Cell Markers and Improve Pancreatic Islet β-cell Function in Humans. Stem Cells Transl Med 2017; 6:1684-1697. [PMID: 28685960 PMCID: PMC5689778 DOI: 10.1002/sctm.17-0078] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/24/2017] [Indexed: 01/09/2023] Open
Abstract
Diabetes is a major global health issue and the number of individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) increases annually across multiple populations. Research to develop a cure must overcome multiple immune dysfunctions and the shortage of pancreatic islet β cells, but these challenges have proven intractable despite intensive research effort more than the past decades. Stem Cell Educator (SCE) therapy-which uses only autologous blood immune cells that are externally exposed to cord blood stem cells adhering to the SCE device, has previously been proven safe and effective in Chinese and Spanish subjects for the improvement of T1D, T2D, and other autoimmune diseases. Here, 4-year follow-up studies demonstrated the long-term safety and clinical efficacy of SCE therapy for the treatment of T1D and T2D. Mechanistic studies found that the nature of platelets was modulated in diabetic subjects after receiving SCE therapy. Platelets and their released mitochondria display immune tolerance-associated markers that can modulate the proliferation and function of immune cells. Notably, platelets also expressed embryonic stem cell- and pancreatic islet β-cell-associated markers that are encoded by mitochondrial DNA. Using freshly-isolated human pancreatic islets, ex vivo studies established that platelet-releasing mitochondria can migrate to pancreatic islets and be taken up by islet β cells, leading to the proliferation and enhancement of islet β-cell functions. These findings reveal new mechanisms underlying SCE therapy and open up new avenues to improve the treatment of diabetes in clinics. Stem Cells Translational Medicine 2017;6:1684-1697.
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Affiliation(s)
- Yong Zhao
- Department of Research, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Zhaoshun Jiang
- Section of Endocrinology, General Hospital of Jinan Military Command, Jinan, Shandong, People's Republic of China
| | - Elias Delgado
- Endocrinology Section, Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Heng Li
- Section of Neurology, Jinan Central Hospital, Jinan, Shandong, People's Republic of China
| | - Huimin Zhou
- Section of Endocrinology, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Wei Hu
- Department of Research, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Marcos Perez-Basterrechea
- Unit of Transplants, Cell Therapy and Regenerative Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Anna Janostakova
- Department of Research, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Qidong Tan
- Section of Endocrinology, General Hospital of Jinan Military Command, Jinan, Shandong, People's Republic of China
| | - Jing Wang
- Section of Endocrinology, General Hospital of Jinan Military Command, Jinan, Shandong, People's Republic of China
| | - Mao Mao
- Department of Research, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Zhaohui Yin
- Section of Endocrinology, General Hospital of Jinan Military Command, Jinan, Shandong, People's Republic of China
| | - Ye Zhang
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, People's Republic of China
| | - Ying Li
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, People's Republic of China
| | - Quanhai Li
- Cell Therapy Center, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Jing Zhou
- Cell Therapy Center, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Yunxiang Li
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, People's Republic of China
| | - Eva Martinez Revuelta
- Hematology and Hemotherapy Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jose Maria García-Gala
- Hematology and Hemotherapy Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Honglan Wang
- Department of Research, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Silvia Perez-Lopez
- Unit of Transplants, Cell Therapy and Regenerative Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Maria Alvarez-Viejo
- Unit of Transplants, Cell Therapy and Regenerative Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Edelmiro Menendez
- Endocrinology Section, Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Thomas Moss
- CORD:USE Cord Blood Bank, Orlando, Florida, USA
| | | | - Jesus Otero
- Unit of Transplants, Cell Therapy and Regenerative Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
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Gerace D, Martiniello-Wilks R, Nassif NT, Lal S, Steptoe R, Simpson AM. CRISPR-targeted genome editing of mesenchymal stem cell-derived therapies for type 1 diabetes: a path to clinical success? Stem Cell Res Ther 2017; 8:62. [PMID: 28279194 PMCID: PMC5345178 DOI: 10.1186/s13287-017-0511-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Due to their ease of isolation, differentiation capabilities, and immunomodulatory properties, the therapeutic potential of mesenchymal stem cells (MSCs) has been assessed in numerous pre-clinical and clinical settings. Currently, whole pancreas or islet transplantation is the only cure for people with type 1 diabetes (T1D) and, due to the autoimmune nature of the disease, MSCs have been utilised either natively or transdifferentiated into insulin-producing cells (IPCs) as an alternative treatment. However, the initial success in pre-clinical animal models has not translated into successful clinical outcomes. Thus, this review will summarise the current state of MSC-derived therapies for the treatment of T1D in both the pre-clinical and clinical setting, in particular their use as an immunomodulatory therapy and targets for the generation of IPCs via gene modification. In this review, we highlight the limitations of current clinical trials of MSCs for the treatment of T1D, and suggest the novel clustered regularly interspaced short palindromic repeat (CRISPR) gene-editing technology and improved clinical trial design as strategies to translate pre-clinical success to the clinical setting.
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Affiliation(s)
- Dario Gerace
- The School of Life Sciences, Chronic Disease Solutions Team and the Centre for Health Technologies, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia
| | - Rosetta Martiniello-Wilks
- The School of Life Sciences, Chronic Disease Solutions Team and the Centre for Health Technologies, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia.,Translational Cancer Research Group, University of Technology Sydney, Sydney, Australia
| | - Najah Therese Nassif
- The School of Life Sciences, Chronic Disease Solutions Team and the Centre for Health Technologies, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia
| | - Sara Lal
- The School of Life Sciences, Chronic Disease Solutions Team and the Centre for Health Technologies, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia.,Neuroscience Research Unit, University of Technology Sydney, Sydney, Australia
| | - Raymond Steptoe
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Ann Margaret Simpson
- The School of Life Sciences, Chronic Disease Solutions Team and the Centre for Health Technologies, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
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12
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Nassar W, El-Ansary M, Sabry D, Mostafa MA, Fayad T, Kotb E, Temraz M, Saad AN, Essa W, Adel H. Umbilical cord mesenchymal stem cells derived extracellular vesicles can safely ameliorate the progression of chronic kidney diseases. Biomater Res 2016; 20:21. [PMID: 27499886 PMCID: PMC4974791 DOI: 10.1186/s40824-016-0068-0] [Citation(s) in RCA: 304] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/04/2016] [Indexed: 12/29/2022] Open
Abstract
Background Bio-products from stem/progenitor cells, such as extracellular vesicles, are likely a new promising approach for reprogramming resident cells in both acute and chronic kidney disease. Forty CKD patients stage III and IV (eGFR 15–60 mg/ml) have been divided into two groups; twenty patients as treatment group “A” and twenty patients as a matching placebo group “B”. Two doses of MSC-derived extracellular vesicles had been administered to patients of group “A”. Blood urea, serum creatinine, urinary albumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) have been used to assess kidney functions and TNF-α, TGF-β1 and IL-10 have been used to assess the amelioration of the inflammatory immune activity. Results Participants in group A exhibited significant improvement of eGFR, serum creatinine level, blood urea and UACR. Patients of the treatment group “A” also exhibited significant increase in plasma levels of TGF-β1, and IL-10 and significant decrease in plasma levels of TNF-α. Participants of the control group B did not show significant improvement in any of the previously mentioned parameters at any time point of the study period. Conclusion Administration of cell-free cord-blood mesenchymal stem cells derived extracellular vesicles (CF-CB-MSCs-EVs) is safe and can ameliorate the inflammatory immune reaction and improve the overall kidney function in grade III-IV CKD patients.
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Affiliation(s)
- Wael Nassar
- Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt ; Department of Internal medicine, Nephrology Section, Faculty of Medicine, October Six University, Cairo, Egypt
| | - Mervat El-Ansary
- Department of clinical pathology, stem cells Section, Faculty of medicine, Cairo University, Cairo, Egypt
| | - Dina Sabry
- Department of Biochemistry, Faculty of medicine, Cairo University, Cairo, Egypt
| | - Mostafa A Mostafa
- Department of Internal medicine, Nephrology Section, Faculty of Medicine, October Six University, Cairo, Egypt
| | - Tarek Fayad
- Department of Internal Medicine, Nephrology Section, Faculty of medicine, Cairo University, Cairo, Egypt
| | - Esam Kotb
- Department of Internal medicine, Nephrology Section, Faculty of Medicine, October Six University, Cairo, Egypt
| | - Mahmoud Temraz
- Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt
| | - Abdel-Naser Saad
- Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt
| | - Wael Essa
- Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt
| | - Heba Adel
- Department of clinical pathology, stem cells Section, Faculty of medicine, Cairo University, Cairo, Egypt
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Medhekar SK, Shende VS, Chincholkar AB. Recent Stem Cell Advances: Cord Blood and Induced Pluripotent Stem Cell for Cardiac Regeneration- a Review. Int J Stem Cells 2016; 9:21-30. [PMID: 27426082 PMCID: PMC4961100 DOI: 10.15283/ijsc.2016.9.1.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 03/07/2016] [Indexed: 12/14/2022] Open
Abstract
Stem cells are primitive self renewing undifferentiated cell that can be differentiated into various types of specialized cells like nerve cell, skin cells, muscle cells, intestinal tissue, and blood cells. Stem cells live in bone marrow where they divide to make new blood cells and produces peripheral stem cells in circulation. Under proper environment and in presence of signaling molecules stem cells begin to develop into specialized tissues and organs. These unique characteristics make them very promising entities for regeneration of damaged tissue. Day by day increase in incidence of heart diseases including left ventricular dysfunction, ischemic heart disease (IHD), congestive heart failure (CHF) are the major cause of morbidity and mortality. However infracted tissue cannot regenerate into healthy tissue. Heart transplantation is only the treatment for such patient. Due to limitation of availability of donor for organ transplantation, a focus is made for alternative and effective therapy to treat such condition. In this review we have discussed the new advances in stem cells such as use of cord stem cells and iPSC technology in cardiac repair. Future approach of CB cells was found to be used in tissue repair which is specifically observed for improvement of left ventricular function and myocardial infarction. Here we have also focused on how iPSC technology is used for regeneration of cardiomyocytes and intiating neovascularization in myocardial infarction and also for study of pathophysiology of various degenerative diseases and genetic disease in research field.
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Affiliation(s)
| | - Vikas Suresh Shende
- Department of Pharmacology, Satara College of Pharmacy, Degaon, Satara (MH), India
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Maria ATJ, Maumus M, Le Quellec A, Jorgensen C, Noël D, Guilpain P. Adipose-Derived Mesenchymal Stem Cells in Autoimmune Disorders: State of the Art and Perspectives for Systemic Sclerosis. Clin Rev Allergy Immunol 2016; 52:234-259. [DOI: 10.1007/s12016-016-8552-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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15
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Wan Y, Garner J, Wu N, Phillip L, Han Y, McDaniel K, Annable T, Zhou T, Francis H, Glaser S, Huang Q, Alpini G, Meng F. Role of stem cells during diabetic liver injury. J Cell Mol Med 2016; 20:195-203. [PMID: 26645107 PMCID: PMC4727564 DOI: 10.1111/jcmm.12723] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/24/2015] [Indexed: 12/18/2022] Open
Abstract
Diabetes mellitus is one of the most severe endocrine metabolic disorders in the world that has serious medical consequences with substantial impacts on the quality of life. Type 2 diabetes is one of the main causes of diabetic liver diseases with the most common being non-alcoholic fatty liver disease. Several factors that may explain the mechanisms related to pathological and functional changes of diabetic liver injury include: insulin resistance, oxidative stress and endoplasmic reticulum stress. The realization that these factors are important in hepatocyte damage and lack of donor livers has led to studies concentrating on the role of stem cells (SCs) in the prevention and treatment of liver injury. Possible avenues that the application of SCs may improve liver injury include but are not limited to: the ability to differentiate into pancreatic β-cells (insulin producing cells), the contribution for hepatocyte regeneration, regulation of lipogenesis, glucogenesis and anti-inflammatory actions. Once further studies are performed to explore the underlying protective mechanisms of SCs and the advantages and disadvantages of its application, there will be a greater understand of the mechanism and therapeutic potential. In this review, we summarize the findings regarding the role of SCs in diabetic liver diseases.
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Affiliation(s)
- Ying Wan
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research, Southern Medical University, Guangzhou, China
| | - Jessica Garner
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Nan Wu
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Levine Phillip
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Yuyan Han
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Kelly McDaniel
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Tami Annable
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Tianhao Zhou
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Heather Francis
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Shannon Glaser
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Qiaobing Huang
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research, Southern Medical University, Guangzhou, China
| | - Gianfranco Alpini
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Fanyin Meng
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
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Modulation of Autoimmune T-Cell Memory by Stem Cell Educator Therapy: Phase 1/2 Clinical Trial. EBioMedicine 2015; 2:2024-36. [PMID: 26844283 PMCID: PMC4703710 DOI: 10.1016/j.ebiom.2015.11.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 10/29/2015] [Accepted: 11/03/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) is a T cell-mediated autoimmune disease that causes a deficit of pancreatic islet β cells. The complexities of overcoming autoimmunity in T1D have contributed to the challenges the research community faces when devising successful treatments with conventional immune therapies. Overcoming autoimmune T cell memory represents one of the key hurdles. METHODS In this open-label, phase 1/phase 2 study, Caucasian T1D patients (N = 15) received two treatments with the Stem Cell Educator (SCE) therapy, an approach that uses human multipotent cord blood-derived multipotent stem cells (CB-SCs). SCE therapy involves a closed-loop system that briefly treats the patient's lymphocytes with CB-SCs in vitro and returns the "educated" lymphocytes (but not the CB-SCs) into the patient's blood circulation. This study is registered with ClinicalTrials.gov, NCT01350219. FINDINGS Clinical data demonstrated that SCE therapy was well tolerated in all subjects. The percentage of naïve CD4(+) T cells was significantly increased at 26 weeks and maintained through the final follow-up at 56 weeks. The percentage of CD4(+) central memory T cells (TCM) was markedly and constantly increased at 18 weeks. Both CD4(+) effector memory T cells (TEM) and CD8(+) TEM cells were considerably decreased at 18 weeks and 26 weeks respectively. Additional clinical data demonstrated the modulation of C-C chemokine receptor 7 (CCR7) expressions on naïve T, TCM, and TEM cells. Following two treatments with SCE therapy, islet β-cell function was improved and maintained in individuals with residual β-cell function, but not in those without residual β-cell function. INTERPRETATION Current clinical data demonstrated the safety and efficacy of SCE therapy in immune modulation. SCE therapy provides lasting reversal of autoimmune memory that could improve islet β-cell function in Caucasian subjects. FUNDING Obra Social "La Caixa", Instituto de Salud Carlos III, Red de Investigación Renal, European Union FEDER Funds, Principado de Asturias, FICYT, and Hackensack University Medical Center Foundation.
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Key Words
- AIRE, autoimmune regulator
- Autoimmunity
- CB-SCs, human cord blood-derived multipotent stem cells
- CCR7, C–C chemokine receptor 7
- Cord blood stem cell
- HLA, human leukocyte antigen
- HbA1C, glycated hemoglobin
- IL, interleukin
- Immune modulation
- M2, muscarinic acetylcholine receptor 2
- MLR, mixed leukocyte reactions
- MNC, mononuclear cells
- Memory T cells
- OGTT, oral glucose tolerance test
- PBMC, peripheral blood mononuclear cells
- R, responder
- S, stimulator
- SCE, Stem Cell Educator
- T1D, type 1 diabetes
- TCM, central memory T cells
- TCR, T-cell receptor
- TEM, effector memory T cells
- TGF-β1, transforming growth factor-β1
- Th, helper T cell
- Tregs, regulatory T cells
- Type 1 diabetes
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He B, Li X, Yu H, Zhou Z. Therapeutic potential of umbilical cord blood cells for type 1 diabetes mellitus. J Diabetes 2015; 7:762-73. [PMID: 25799887 DOI: 10.1111/1753-0407.12286] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 02/25/2015] [Accepted: 03/09/2015] [Indexed: 12/18/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) is a chronic disorder that results from autoimmune-mediated destruction of pancreatic islet β-cells. However, to date, no conventional intervention has successfully treated the disease. The optimal therapeutic method for T1DM should effectively control the autoimmunity, restore immune homeostasis, preserve residual β-cells, reverse β-cell destruction, and protect the regenerated insulin-producing cells against re-attack. Umbilical cord blood is rich in regulatory T (T(reg)) cells and multiple types of stem cells that exhibit immunomodulating potential and hold promise in their ability to restore peripheral tolerance towards pancreatic islet β-cells through remodeling of immune responses and suppression of autoreactive T cells. Recently, reinfusion of autologous umbilical cord blood or immune cells from cord blood has been proposed as a novel therapy for T1DM, with the advantages of no risk to the donors, minimal ethical concerns, a low incidence of graft-versus-host disease and easy accessibility. In this review, we revisit the role of autologous umbilical cord blood or immune cells from cord blood-based applications for the treatment of T1DM.
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Affiliation(s)
- Binbin He
- Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, Diabetes Center, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, China
| | - Xia Li
- Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, Diabetes Center, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, China
| | - Haibo Yu
- Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, Diabetes Center, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, China
| | - Zhiguang Zhou
- Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, Diabetes Center, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, China
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Li Y, Yan B, Wang H, Li H, Li Q, Zhao D, Chen Y, Zhang Y, Li W, Zhang J, Wang S, Shen J, Li Y, Guindi E, Zhao Y. Hair regrowth in alopecia areata patients following Stem Cell Educator therapy. BMC Med 2015; 13:87. [PMID: 25896390 PMCID: PMC4417286 DOI: 10.1186/s12916-015-0331-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/17/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Alopecia areata (AA) is one of the most common autoimmune diseases and targets the hair follicles, with high impact on the quality of life and self-esteem of patients due to hair loss. Clinical management and outcomes are challenged by current limited immunosuppressive and immunomodulating regimens. METHODS We have developed a Stem Cell Educator therapy in which a patient's blood is circulated through a closed-loop system that separates mononuclear cells from the whole blood, allows the cells to briefly interact with adherent human cord blood-derived multipotent stem cells (CB-SC), and returns the "educated" autologous cells to the patient's circulation. In an open-label, phase 1/phase 2 study, patients (N = 9) with severe AA received one treatment with the Stem Cell Educator therapy. The median age was 20 years (median alopecic duration, 5 years). RESULTS Clinical data demonstrated that patients with severe AA achieved improved hair regrowth and quality of life after receiving Stem Cell Educator therapy. Flow cytometry revealed the up-regulation of Th2 cytokines and restoration of balancing Th1/Th2/Th3 cytokine production in the peripheral blood of AA subjects. Immunohistochemistry indicated the formation of a "ring of transforming growth factor beta 1 (TGF-β1)" around the hair follicles, leading to the restoration of immune privilege of hair follicles and the protection of newly generated hair follicles against autoimmune destruction. Mechanistic studies revealed that co-culture with CB-SC may up-regulate the expression of coinhibitory molecules B and T lymphocyte attenuator (BTLA) and programmed death-1 receptor (PD-1) on CD8β(+)NKG2D(+) effector T cells and suppress their proliferation via herpesvirus entry mediator (HVEM) ligands and programmed death-1 ligand (PD-L1) on CB-SCs. CONCLUSIONS Current clinical data demonstrated the safety and efficacy of the Stem Cell Educator therapy for the treatment of AA. This innovative approach produced lasting improvement in hair regrowth in subjects with moderate or severe AA. TRIAL REGISTRATION ClinicalTrials.gov, NCT01673789, 21 August 2012.
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Affiliation(s)
- Yanjia Li
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050031, P.R. China.
| | - Baoyong Yan
- Cell Therapy Center, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050031, P.R. China.
| | - Hepeng Wang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050031, P.R. China.
| | - Heng Li
- Department of Neurology, Jinan Central Hospital, Shandong University, Jinan, Shandong, 250013, P.R. China.
| | - Quanhai Li
- Cell Therapy Center, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050031, P.R. China.
| | - Dong Zhao
- Department of Pathology, Jinan Central Hospital, Shandong University, Jinan, Shandong, 250013, P.R. China.
| | - Yana Chen
- Department of Obstetrics, Jinan Central Hospital, Shandong University, Jinan, Shandong, 250013, P.R. China.
| | - Ye Zhang
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, 250055, P.R. China.
| | - Wenxia Li
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, 250055, P.R. China.
| | - Jun Zhang
- Cell Therapy Center, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050031, P.R. China.
| | - Shanfeng Wang
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, 250055, P.R. China.
| | - Jie Shen
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, 250055, P.R. China.
| | - Yunxiang Li
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, 250055, P.R. China.
| | | | - Yong Zhao
- Tianhe Stem Cell Biotechnologies Inc., Jinan, Shandong, 250055, P.R. China. .,Department of Research, Hackensack University Medical Center, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
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Xiao N, Zhao X, Luo P, Guo J, Zhao Q, Lu G, Cheng L. Co-transplantation of mesenchymal stromal cells and cord blood cells in treatment of diabetes. Cytotherapy 2014; 15:1374-84. [PMID: 24094489 DOI: 10.1016/j.jcyt.2013.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 06/04/2013] [Accepted: 06/19/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND AIMS Stem cells provide a promising source for treatment of type 1 diabetes, but the treatment strategy and mechanism remain unclear. The aims of this study were to investigate whether co-transplantation of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) and cord blood mononuclear cells (CB-MNCs) could reverse hyperglycemia in type 1 diabetic mice and to determine the appropriate ratio for co-transplantation. The treatment mechanism was also studied. METHODS A simple and efficient isolation method was developed to generate qualified UC-MSCs. UC-MSCs and CB-MNCs were then transplanted into type 1 diabetic mice at different ratios (UC-MSCs to CB-MNCs = 1:1, 1:4, 1:10) to observe the change in blood glucose concentration. Histology, immunohistochemistry, and human Alu polymerase chain reaction assay were performed to evaluate for the presence of donor-derived cells and the repair of endogenous islets. We also induced UC-MSCs into islet-like cells under specific culture conditions to determine their differentiate potential in vitro. RESULTS Co-transplantation of UC-MSCs and CB-MNCs at a ratio of 1:4 effectively reversed hyperglycemia in diabetic mice. The detection of human Alu sequence indicated that the engraftment of donor-derived cells had homed into the recipient's pancreas and kidney. Although neither human insulin nor human nuclei antigen was detected in the regenerated pancreas, UC-MSCs could differentiate into insulin-secreted cells in vitro. CONCLUSIONS Co-transplantation of UC-MSCs and CB-MNCs at a ratio of 1:4 could efficiently reverse hyperglycemia and repair pancreatic tissue.
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Affiliation(s)
- Na Xiao
- Department of Adult Stem Cell, Institute of Reproduction and Stem Cell Engineering, Central South University, Changsha, Hunan, China
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Chhabra P, Brayman KL. Overcoming barriers in clinical islet transplantation: current limitations and future prospects. Curr Probl Surg 2014; 51:49-86. [PMID: 24411187 DOI: 10.1067/j.cpsurg.2013.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Zhu HH, Huang XJ. Current status of stem cell therapy in China. Int J Hematol Oncol 2013. [DOI: 10.2217/ijh.13.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Stem cells, including embryonic stem cells, somatic stem cells and induced pluripotent stem cells, are a cell population with strong self-renewal capability and multidirectional differentiation potential. Stem cells can differentiate into specific tissues and organs under given conditions and represent an ideal source for the repair and regeneration of tissues and organs. Medical study of stem cell transformation has become an international research focus. This article reviews the status of stem cell therapy in China.
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Affiliation(s)
- Hong-Hu Zhu
- Peking University People’s Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, China
| | - Xiao-Jun Huang
- Peking University People’s Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, China
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Zhao Y, Jiang Z, Zhao T, Ye M, Hu C, Zhou H, Yin Z, Chen Y, Zhang Y, Wang S, Shen J, Thaker H, Jain S, Li Y, Diao Y, Chen Y, Sun X, Fisk MB, Li H. Targeting insulin resistance in type 2 diabetes via immune modulation of cord blood-derived multipotent stem cells (CB-SCs) in stem cell educator therapy: phase I/II clinical trial. BMC Med 2013; 11:160. [PMID: 23837842 PMCID: PMC3716981 DOI: 10.1186/1741-7015-11-160] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 05/30/2013] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes (T2D) is increasing worldwide and creating a significant burden on health systems, highlighting the need for the development of innovative therapeutic approaches to overcome immune dysfunction, which is likely a key factor in the development of insulin resistance in T2D. It suggests that immune modulation may be a useful tool in treating the disease. METHODS In an open-label, phase 1/phase 2 study, patients (N=36) with long-standing T2D were divided into three groups (Group A, oral medications, n=18; Group B, oral medications+insulin injections, n=11; Group C having impaired β-cell function with oral medications+insulin injections, n=7). All patients received one treatment with the Stem Cell Educator therapy in which a patient's blood is circulated through a closed-loop system that separates mononuclear cells from the whole blood, briefly co-cultures them with adherent cord blood-derived multipotent stem cells (CB-SCs), and returns the educated autologous cells to the patient's circulation. RESULTS Clinical findings indicate that T2D patients achieve improved metabolic control and reduced inflammation markers after receiving Stem Cell Educator therapy. Median glycated hemoglobin (HbA1C) in Group A and B was significantly reduced from 8.61%±1.12 at baseline to 7.25%±0.58 at 12 weeks (P=2.62E-06), and 7.33%±1.02 at one year post-treatment (P=0.0002). Homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) demonstrated that insulin sensitivity was improved post-treatment. Notably, the islet beta-cell function in Group C subjects was markedly recovered, as demonstrated by the restoration of C-peptide levels. Mechanistic studies revealed that Stem Cell Educator therapy reverses immune dysfunctions through immune modulation on monocytes and balancing Th1/Th2/Th3 cytokine production. CONCLUSIONS Clinical data from the current phase 1/phase 2 study demonstrate that Stem Cell Educator therapy is a safe approach that produces lasting improvement in metabolic control for individuals with moderate or severe T2D who receive a single treatment. In addition, this approach does not appear to have the safety and ethical concerns associated with conventional stem cell-based approaches. TRIAL REGISTRATION ClinicalTrials.gov number, NCT01415726.
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Affiliation(s)
- Yong Zhao
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, 1819 W, Polk Street, Chicago, IL 60612, USA.
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Abstract
Type 1 diabetes mellitus (T1D) is a chronic, multifactorial autoimmune disease that involves the progressive destruction of pancreatic β-cells, ultimately resulting in the loss of insulin production and secretion. The goal of clinical intervention is to prevent or arrest the onset and progression of autoimmunity, reverse β-cell destruction, and restore glycometabolic and immune homeostasis. Despite promising outcomes observed with islet transplantation and advancements in immunomodulatory therapies, the need for an effective cell replacement strategy for curing T1D still persists. Stem cell therapy offers a solution to the cited challenges of islet transplantation. While the regenerative potential of stem cells can be harnessed to make available a self-replenishing supply of glucose-responsive insulin-producing cells, their immunomodulatory properties may potentially be used to prevent, arrest, or reverse autoimmunity, ameliorate innate/alloimmune graft rejection, and prevent recurrence of the disease. Herein, we discuss the therapeutic potential of stem cells derived from a variety of sources for the cure of T1D, for example, embryonic stem cells, induced pluripotent stem cells, bone marrow-derived hematopoietic stem cells, and multipotent mesenchymal stromal cells derived from bone marrow, umbilical cord blood, and adipose tissue. The benefits of combinatorial approaches designed to ensure the successful clinical translation of stem cell therapeutic strategies, such as approaches combining effective stem cell strategies with islet transplantation, immunomodulatory drug regimens, and/or novel bioengineering techniques, are also discussed. To conclude, the application of stem cell therapy in the cure for T1D appears extremely promising.
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Affiliation(s)
- Preeti Chhabra
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Kenneth L. Brayman
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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Cipriani P, Carubbi F, Liakouli V, Marrelli A, Perricone C, Perricone R, Alesse E, Giacomelli R. Stem cells in autoimmune diseases: Implications for pathogenesis and future trends in therapy. Autoimmun Rev 2012. [PMID: 23183379 DOI: 10.1016/j.autrev.2012.10.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In this review we report the recent progresses, available in the literature, concerning the biology and the potential therapeutic role of both mesenchymal stem cells (MSCs) and hematopoietic stem cells in autoimmune diseases. Mesenchymal stem cells (MSCs) are responsible for the normal turnover and maintenance of adult mesenchymal tissues and their pleiotropic nature allows them to sense and respond to an event in the local environment, be it injury or inflammation. Recently, MSCs have been shown to have immune-modulatory properties and immunosuppressive capacities, acting on different immune cells both in vitro and in vivo, in addition to an immunologically privileged phenotype. Moreover, several works suggest that MSCs are defective in autoimmune diseases. These aspects are now considered the most intriguing aspect of their biology, introducing the possibility that these cells might be used as effective therapy in autoimmune diseases. Autoimmune diseases represent a failure of normal immune regulatory processes as they are characterized by activation and expansion of immune cell subsets in response to non-pathogenic stimuli. As autoimmune diseases can be transferred, or alternatively, cured, by stem cell transplantation, a defect in the hemopoietic stem cell as a cause of autoimmune diseases may be postulated. The rationale for autologous hematopoietic stem cell transplantation (HSCT) in autoimmune diseases is the ablation of an aberrant or self-reactive immune system by chemotherapy and regeneration of a new and hopefully self-tolerant immune system from hematopoietic stem cells. In the past 15years, more than 1500 patients worldwide have received HSCT, mostly autologous, as treatment for a severe autoimmune disease and the majority were affected by multiple sclerosis, systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, juvenile idiopathic arthritis and idiopathic cytopenic purpura.
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Affiliation(s)
- Paola Cipriani
- Rheumatology Unit, Clinical Science and Biotechnology Department, University of L'Aquila, Italy.
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Abstract
Type 1 diabetes (T1D) is a T cell-mediated autoimmune disease that causes the deficit of pancreatic islet β cells. A true cure has proven elusive despite intensive research pressure by using conventional approaches over the past 25 years. The situation highlights the challenges we face in conquering this disease. Alternative approaches are needed. Increasing evidence demonstrates that stem cells possess the function of immune modulation. We established the Stem Cell Educator therapy by using cord blood-derived multipotent stem cells (CB-SCs). A closed-loop system that circulates a patient's blood through a blood cell separator, briefly co-cultures the patient's lymphocytes with adherent CB-SCs in vitro, and returns the educated lymphocytes (but not the CB-SCs) to the patient's circulation. Our clinical trial reveals that a single treatment with the Stem Cell Educator provides lasting reversal of autoimmunity that allows regeneration of islet β cells and improvement of metabolic control in subjects with long-standing T1D.
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Affiliation(s)
- Yong Zhao
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Zhou YN, Zhu CY, Li JP. Co-transplantation of islets and umbilical cord mesenchymal stem cells improves graft activity and function in rats. Shijie Huaren Xiaohua Zazhi 2012; 20:2601-2607. [DOI: 10.11569/wcjd.v20.i27.2601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine the effect of co-transplantation of islets and umbilical cord mesenchymal stem cells (UCMSCs) on graft activity and function in rats.
METHODS: Streptozotocin-induced diabetic Sprague-Dawley (SD) rats were divided into four groups, with (1) 500 islets, (2) 1 to 5×106 UCMSCs, (3) 500 islets and 1 to 5×106 UCMSCs; and (4) normal saline transplanted under the kidney capsule, respectively. All rats were evaluated for blood glucose, serum insulin, glucose tolerance, and the rate of normoglycaemia (blood glucose ≤ 11.1 mmol/L) up to postoperative day 28.
RESULTS: Blood glucose was lowest and serum insulin was highest in the islet+UCMSCs group relative to the islet only group (both P < 0.05). The rate of normoglycaemia was better in the co-transplantation group than in the islet only group (P < 0.05). However, there were no differences in the parameters detected between the sham operation group and UCMSCs alone group, and no normoglycemic rats were found in the UCMSCs alone group.
CONCLUSION: Co-transplantation of umbilical cord mesenchymal stem cells with islets is associated with enhanced islet graft activity and function.
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Ilic D, Miere C, Lazic E. Umbilical cord blood stem cells: clinical trials in non-hematological disorders. Br Med Bull 2012; 102:43-57. [PMID: 22544780 DOI: 10.1093/bmb/lds008] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Umbilical cord blood (UCB) has become the second most common source of stem cells for cell therapy. The recent boom in stem cell research and public fascination with promises of stem cell-based therapies, fueled by the media, have led researchers to explore the potential of UCB stem cells in therapy for non-hematological disorders. SOURCES OF DATA ClinicalTrials.gov database searched with key words 'cord blood stem cells' on December 28, 2011. AREAS OF AGREEMENT As a rich source of the most primitive hematopoietic stem cells, UCB has a strong regenerative potential in stem cell-based-therapy for hematological disorders. AREAS OF CONTROVERSY Potential of UCB stem cells in therapy for non-hematological disorders. GROWING POINTS Increasing number of clinical trials with UCB stem cell-based therapy for a variety of diseases. AREAS TIMELY FOR DEVELOPING RESEARCH A need for standardization of criteria for selection of UCB units for stem cell-based therapy, outcome measures and long-term follow-up.
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Affiliation(s)
- Dusko Ilic
- Embryonic Stem Cell Laboratories, Guy's Assisted Conception Unit, Division of Women’s Health, King's College School of Medicine, London, UK.
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29
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Li X, Li H, Bi J, Chen Y, Jain S, Zhao Y. Human cord blood-derived multipotent stem cells (CB-SCs) treated with all-trans-retinoic acid (ATRA) give rise to dopamine neurons. Biochem Biophys Res Commun 2012; 419:110-6. [DOI: 10.1016/j.bbrc.2012.01.142] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 01/30/2012] [Indexed: 10/14/2022]
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30
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Zhao Y, Jiang Z, Zhao T, Ye M, Hu C, Yin Z, Li H, Zhang Y, Diao Y, Li Y, Chen Y, Sun X, Fisk MB, Skidgel R, Holterman M, Prabhakar B, Mazzone T. Reversal of type 1 diabetes via islet β cell regeneration following immune modulation by cord blood-derived multipotent stem cells. BMC Med 2012; 10:3. [PMID: 22233865 PMCID: PMC3322343 DOI: 10.1186/1741-7015-10-3] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 01/10/2012] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Inability to control autoimmunity is the primary barrier to developing a cure for type 1 diabetes (T1D). Evidence that human cord blood-derived multipotent stem cells (CB-SCs) can control autoimmune responses by altering regulatory T cells (Tregs) and human islet β cell-specific T cell clones offers promise for a new approach to overcome the autoimmunity underlying T1D. METHODS We developed a procedure for Stem Cell Educator therapy in which a patient's blood is circulated through a closed-loop system that separates lymphocytes from the whole blood and briefly co-cultures them with adherent CB-SCs before returning them to the patient's circulation. In an open-label, phase1/phase 2 study, patients (n=15) with T1D received one treatment with the Stem Cell Educator. Median age was 29 years (range: 15 to 41), and median diabetic history was 8 years (range: 1 to 21). RESULTS Stem Cell Educator therapy was well tolerated in all participants with minimal pain from two venipunctures and no adverse events. Stem Cell Educator therapy can markedly improve C-peptide levels, reduce the median glycated hemoglobin A1C (HbA1C) values, and decrease the median daily dose of insulin in patients with some residual β cell function (n=6) and patients with no residual pancreatic islet β cell function (n=6). Treatment also produced an increase in basal and glucose-stimulated C-peptide levels through 40 weeks. However, participants in the Control Group (n=3) did not exhibit significant change at any follow-up. Individuals who received Stem Cell Educator therapy exhibited increased expression of co-stimulating molecules (specifically, CD28 and ICOS), increases in the number of CD4+CD25+Foxp3+ Tregs, and restoration of Th1/Th2/Th3 cytokine balance. CONCLUSIONS Stem Cell Educator therapy is safe, and in individuals with moderate or severe T1D, a single treatment produces lasting improvement in metabolic control. Initial results indicate Stem Cell Educator therapy reverses autoimmunity and promotes regeneration of islet β cells. Successful immune modulation by CB-SCs and the resulting clinical improvement in patient status may have important implications for other autoimmune and inflammation-related diseases without the safety and ethical concerns associated with conventional stem cell-based approaches. TRIAL REGISTRATION ClinicalTrials.gov number, NCT01350219.
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Affiliation(s)
- Yong Zhao
- Section of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA.
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Gálvez P, Ruiz A, Clares B. El futuro de la medicina clínica hacia nuevas terapias: terapia celular, génica y nanomedicina. Med Clin (Barc) 2011; 137:645-9. [DOI: 10.1016/j.medcli.2010.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 12/03/2010] [Accepted: 12/14/2010] [Indexed: 01/06/2023]
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Bhandari DR, Seo KW, Sun B, Seo MS, Kim HS, Seo YJ, Marcin J, Forraz N, Roy HL, Larry D, Colin M, Kang KS. The simplest method for in vitro β-cell production from human adult stem cells. Differentiation 2011; 82:144-52. [DOI: 10.1016/j.diff.2011.06.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 05/10/2011] [Accepted: 06/21/2011] [Indexed: 11/16/2022]
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33
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Zhao Y, Jiang Z, Guo C. New hope for type 2 diabetics: targeting insulin resistance through the immune modulation of stem cells. Autoimmun Rev 2011; 11:137-42. [PMID: 21964164 DOI: 10.1016/j.autrev.2011.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 09/11/2011] [Indexed: 12/13/2022]
Abstract
The prevalence of type 2 diabetes (T2D) is increasing worldwide, highlighting the need for a better understanding of the pathogenesis of the disease and the development of innovative therapeutic approaches for the prevention and cure of the condition. Mounting evidence points to the involvement of immune dysfunction in insulin resistance in T2D, suggesting that immune modulation may be a useful tool in treating the disease. Recent advances in the use of adult stem cells from human umbilical cord blood and bone marrow for immune modulation hold promise for overcoming immune dysfunction in T2D without many of the complications associated with traditional immunosuppressive therapies. This review focuses on recent progress in the use of immune modulation in T2D and discusses the potential for future therapies. New insights are provided on the use of cord blood-derived multipotent stem cells (CB-SC) in T2D.
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Affiliation(s)
- Yong Zhao
- Section of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
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34
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Zhu CY, Li JP. Cotransplantation of mesenchymal stem cells and islet in the treatment of type 1 diabetes mellitus: recent progress. Shijie Huaren Xiaohua Zazhi 2011; 19:2546-2550. [DOI: 10.11569/wcjd.v19.i24.2546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Islet transplantation for type 1 diabetes mellitus (T1DM) is limited by the lack of nutrients and presence of transplantation-associated inflammation. Most patients still need to be given a small dose of exogenous insulin in the following 3-5 years after islet transplantation. Cotransplantation of mesenchymal stem cells (MSCs) and islet holds great promise for the treatment of T1DM, because it can regulate the immune responses and overcome the shortage of trophic molecules. However, cotransplantation-associated tumorigenesis and the potential for metastasis in vivo should be also taken into consideration. In this review, we focus on the immunomodulatory properties, trophic effect and the potential side effects of cotransplantation of MSC and islet in the treatment of T1DM.
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35
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Abstract
There is now growing evidence that autoimmunity is the common trait connecting multiple clinical phenotypes albeit differences in tissue specificity, pathogenetic mechanisms, and therapeutic approaches cannot be overlooked. Over the past years we witnessed a constant growth of the number of publications related to autoimmune diseases in peer-reviewed journals of the immunology area. Original data referred to factors from common injury pathways (i.e. T helper 17 cells, serum autoantibodies, or vitamin D) and specific diseases such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. As an example, the issue of a latitudinal gradient in the prevalence and incidence rates has been proposed for all autoimmune diseases and was recently coined as geoepidemiology to suggest new environmental triggers for tolerance breakdown. The present article is aimed at reviewing the articles that were published over the past year in the major autoimmunity and immunology journals.
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Affiliation(s)
- Carlo Selmi
- Autoimmunity and Metabolism Unit, Department of Medicine, IRCCS Istituto Clinico Humanitas, Italy.
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36
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Butler MG, Menitove JE. Umbilical cord blood banking: an update. J Assist Reprod Genet 2011; 28:669-76. [PMID: 21617932 DOI: 10.1007/s10815-011-9577-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 04/29/2011] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Umbilical cord blood is a potential vast source of primitive hematopoietic stem and progenitor cells available for clinical application to reconstitute the hematopoietic system and/or restore immunological function in affected individuals requiring treatment. Cord blood can be used as an alternative source for bone marrow transplantation and its use is developing into a new field of treatment for pediatric and adult patients presenting with hematological disorders, immunological defects and specific genetic diseases. DISCUSSION More than 25,000 allogeneic cord blood transplantations have been performed worldwide since the first cord blood transplantation in 1988. There are two banking options for storing umbilical cord blood [private (family) and public]. Cord blood stored in private banks are used for either autologous or allogeneic transplants for the infant donor or related family members but private cord blood banks are not searchable or available to the public. More than 780,000 cord blood units are stored in over 130 private cord blood banks, worldwide, and over 400,000 units in more than 100 quality controlled public cord blood banks. CONCLUSIONS Researchers continue to evaluate the usefulness of cord blood cells in treating human diseases or disorders for purposes other than hematological disorders including heart disease, strokes, brain or spinal cord injuries and cancer. This review summarizes the status of umbilical cord blood banking, its history and current and potential use in the treatment of human disease.
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Affiliation(s)
- Merlin G Butler
- Departments of Psychiatry & Behavioral Sciences and Pediatrics, Kansas University Medical Center, Kansas City, KS 66160, USA.
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37
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Ben-Ami E, Berrih-Aknin S, Miller A. Mesenchymal stem cells as an immunomodulatory therapeutic strategy for autoimmune diseases. Autoimmun Rev 2011; 10:410-5. [PMID: 21256250 DOI: 10.1016/j.autrev.2011.01.005] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Accepted: 01/08/2011] [Indexed: 12/13/2022]
Abstract
Mesenchymal stem cells (MSCs) are non-hematopoietic, multipotent progenitor cells which can be isolated from various human adult tissues. In recent years, MSCs have been shown to possess broad immunoregulatory capabilities, modulating both adaptive and innate immunity. This review discusses the documented immunomodulatory capabilities of the MSCs, the possible mechanisms underlying these functions and presents the potential of using this stem cell-based approach as an immunomodulatory tool for the treatment of autoimmune diseases.
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Affiliation(s)
- Eyal Ben-Ami
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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