Diabetic neuropathy is a condition in which perpetually high blood sugar causes nerve damage, resulting in a myriad of symptoms such as numbness, reduced ability to detect painful stimuli, muscle weakness, pain, and muscle spasms. Diabetic neuropathy affects up to 60 percent of patients with diabetes, is often the cause of foot ulcers, and can ultimately result in amputations.  There is no curative therapy for diabetic neuropathy, however now, a recent study carried out by a team of researchers in the U.S. and Korea have found that laboratory animals modeled with diabetic neuropathy can experience both angiogenesis (blood vessel growth) and nerve re-myelination following injections of mesenchymal stem cells derived from bone marrow (BM-MSCs).

The team used mesenchymal stem cells, which can be easily isolated from a variety of sources, such as adipose (fat) tissues, tendons, peripheral blood, umbilical cord blood, and bone marrow. Previous studies show that MSCs derived from bone marrow (BM-MSCs) have been among the most successfully transplanted cells, offering therapeutic benefits for a wide range of conditions, from serious burns to cardiovascular diseases, including heart attack and stroke.

The current study randomly assigned BM-MSC or saline injection 12 weeks after the induction of diabetes to laboratory rats models. The non-diabetic control group of rats was age- and sex-matched.  Diabetic neuropathy was confirmed by latency in nerve conduction velocity tests.

The researchers investigated whether local transplantation of BM-MSCs could attenuate or reverse experimental  diabetic neuropathy by modulating angiogenesis and restoring myelin, the electrically insulating substance surrounding nerves that is reduced by diabetic neuropathy.  The data findings provided the first evidence that intramuscular injected BM-MSCs migrate to nerves and can play a therapeutic role.

The team state that their findings indicate that intramuscular injection of MSCs resulted in an increase of multiple angiogenic and neurotrophic factors associated with blood vessel growth and subsequently aided the survival of diabetic nerves, suggesting that BM-MSC transplantation restored both the myelin sheath and nerve cells in diabetic sciatic nerves.  They go to add that they identified several new mechanisms by which MSCs can improve diabetic neuropathy.  First, it was demonstrated that numerous engraftments migrated to and survived in the diabetic nerves. Secondly it was demonstrated a robust increase in vascularity. Third, it was found the first evidence that MSCs can directly modulate re-myelination and axonal regeneration.

The researchers surmise that  diabetic neuropathy can be an initial target for cell therapy and that transplantation of BM- MSCs represents a novel therapeutic option for treating diabetic neuropathy.  The team note that currently, the only treatment options available for  diabetic neuropathy are palliative (focused on alleviating pain) in nature, or are directed at slowing the progression of the disease by tightly controlling blood sugar levels.

The team conclude that this study offers new insight into the benefits of cell therapy as a possible treatment option for a disease that significantly diminishes quality of life for diabetic patients. Future plans for this collaboration include safety and efficacy for human application must be evaluated to further determine the feasibility of BM-MSC transplantation for treatment of diabetic neuropathy.

Source:   Emory University School of Medicine