According to the International Diabetes Federation , DM affects 300milion people worldwide(in 2016) causing substantial morbidity and mortality. Stem cell therapy represents a highly promising new modality of treatment for advanced diabetes.
However , many concerns about the type of stem cells, the transplantation procedure, and long term recovery remain to be addressed. Many studies have reported that stem cell transplantation promote program and protection of pancreatic beta cell in diabetic mice without the differentiation of transplanted cells into pancreatic beta cells that the improvement is due to a paracrine effect of the transplanted cells. However, given the complexity of the treatment and the potential ethical and translational consederations, just a few have moved to clinic.
In this circumstances, we investigated effects of factors secreted by dental pulp stem cells human exfoliated teeth(SHED) on beta-cell function and survival. Conditioned medium(CM) from SHED was collected after culturing in serum free DMEM . The insuline level in SHEDCM were undetectable. High calorie feeding diabetic mice were injected with DMEM as a control and SHEDCM for 61 days. Histological and biochemical studies were carried out in several time points.
The H&E staining showed that SHEDCM treatment preserved the islet mass and maintained the normal round shape compared with the other treatment groups.
Administration of SHEDCM improved glucose intolerance in diabetic mice and effect continued for 20 days after end of treatment increased pancreatic insulin content and beta-cell mass through proliferation and an intraperitoneal glucose test revealed enhanced insulin.
Based on animal study we performed the first in human study by using SHEDCM for diabetes type II patients. Eleven patients were between 59 and 69 years of age and had a clinical diagnosis of diabetes type II. The protocol in this study was in this study was established on the basis of MABEL( Minimum Anticipated Biological Effect Level).
Average of HbA1c in 11 patients were 8.5 before treatment and 6.8 at day 40 after treatment. HOMA-R level dramatically decreased from 3.93 to 1.56 on average at day 40 after treatment. Also LOX-index showed an obvious improvement with its means level from 1424 to 663 at day14 after treatment.