Cell Therapy for Diabetes

Diabetes is one of the world’s most widespread diseases (more than 400 million people suffer from it currently, and up to 600 million sufferers are predicted by 2035). Severe complications of diabetes include kidney failure, neuropathy, loss of vision, heart disease, etc. Despite the potential of modern technologies to control blood sugar (e.g., using insulin pumps), it is still impossible to thoroughly reproduce insulin release by healthy human beta cells. Replacing missing beta cells by transplanting islets of Langerhans would be a perfect way to treat patients with diabetes. Although such transplantation has been performed on hundreds of patients since 1999, in general, it has not become widely available due to the deficit of islets, the need for immunosuppression, and the high price. Besides, most treated patients had to return to external insulin four years after the transplantation procedure. Significant progress has been achieved in generating islet cells from embryonic stem cells (ESCs) and induced pluripotent stem cells (iPS cells). Besides, adult stem cells, including mesenchymal stem cells (MSCs), were applied for diabetes therapy, demonstrating their safety and efficiency in clinical trials. In our chapter, we discuss the advantages and problems of cell therapy based on the use of islet cells derived from ESCs and iPS cells and on the transplantation of MSCs and MSCs-derived exosomes. The results of the most critical preclinical and clinical studies are covered.