Diabetes & Metabolism
Volume 35, n° 2
pages 85-93 (avril 2009)
Doi : 10.1016/j.diabet.2008.10.003
Received : 3 July 2008 ;
accepted : 7 October 2008 | | | Mesenchymal stem cells: Stem cell therapy perspectives for type 1 diabetes
Les cellules souches mésenchymateuses comme nouvelle approche thérapeutique du diabète de type 1L. Vija a, b, D. Farge c, J.-F. Gautier b, P. Vexiau b, C. Dumitrache d, A. Bourgarit c, F. Verrecchia a, J. Larghero e, ⁎ 
a Inserm U697, Paris, France b Department of Endocrinology Diabetes and Nutrition, Saint Louis Hospital, AP–HP, Paris, France c Department of Internal Medicine, Saint Louis Hospital, AP–HP, Paris, France d Endocrinology Institute “CI Parhon”, Bucharest, Romania e Cell Therapy Unit, Saint Louis Hospital, AP–HP, University Paris 7 Paris-Diderot, Inserm Unit 718, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
 Corresponding author.Mesenchymal stem cells (MSCs) are multipotent non-haematopoietic progenitor cells that are being explored as a promising new treatment for tissue regeneration. Although their immunomodulatory properties are not yet completely understood, their low immunogenic potential together with their effects on immune response make them a promising therapeutic tool for severe refractory autoimmune diseases. Type 1 diabetes is characterized by T cell-mediated autoimmune destruction of pancreatic β cells. While insulin replacement represents the current therapy for type 1 diabetes, its metabolic control remains difficult, as exogenous insulin cannot exactly mimic the physiology of insulin secretion. Pancreatic or islet transplantation can provide exogenous insulin independence, but is limited by its intrinsic complications and the scarcity of organ donors. In this context, stem cell therapy, based on the generation of insulin-producing cells (IPCs) derived from MSCs, represents an attractive possibility. In this review, we provide a brief characterization of MSC immunomodulatory effects, and present the current experimental evidence for the potential therapeutic efficacy of MSC transplantation in diabetes. Les cellules souches mésenchymateuses (CSM) sont des cellules progénitrices non hématopoïétiques multipotentes qui constituent aujourd’hui un outil thérapeutique prometteur pour la régénération et la réparation tissulaire. Bien que les mécanismes exacts de l’action immunomodulatrice des CSM in vitro ne soient pas totalement éclaircis, leurs propriétés immunosuppressives ont conduit à leur utilisation en clinique humaine pour le traitement de certaines maladies auto-immunes. Le diabète de type 1 est caractérisé par une destruction auto-immune des cellules β du pancreas, médiée en partie par les lymphocytes T. L’insulinothérapie permet, en partie, de palier le déficit en insuline endogène et de contrôler la glycémie, mais ne représente pas un traitement curatif de la maladie. La greffe de pancréas et la transplantation d’îlots pancréatiques permettent d’obtenir une insulino-indépendance mais sont limitées par les complications liées à ces approches thérapeutiques et par les difficultés inhérentes au don d’organe. Dans ce contexte, les thérapies cellulaires fondées sur l’utilisation de cellules productrices d’insuline (IPCs) dérivées des CSM représentent des perspectives thérapeutiques séduisantes. Dans cette revue, nous présentons les principales caractéristiques fonctionnelles des CSM ainsi que les données expérimentales qui suggèrent l’efficacité potentielle de la greffe de CSM ou de cellules dérivées des CSM dans le traitement du diabète de type 1. Keywords : Mesenchymal stem cells, Type 1 diabetes, Insulin-producing cells, Stem cell therapy, Immunosuppression, Review Mots clés : Cellules souches mésenchymateuses, Diabète de type 1, Cellules productrices d’insuline, Thérapies cellulaires, Immunosuppression, Revue | | | | | |
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