Stem cells from the uterus are effective in diabetes treatment

Stem cells are known for their ability to differentiate into many cell types. It is no wonder that scientists are exploring the possibilities of turning them into cells of our choice, in order to recreate tissues where the body is unable to do so. In a latest effort in the ongoing battle to cure Diabetes, researchers have found that stem cells of the stromal lining of the uterus are seemingly capable of curing the disease in mice. In Diabetes Mellitus type 1 (DM1), the pancreatic cells that produce insulin, a hormone that regulates blood glucose levels, are being destroyed by the immune system. Over the years, many different methods have been explored to restore the insulin producing capabilities of the body. Transplant of pancreatic islets, which include the ß-cells that normally produce insulin, are a promising novel therapeutic for DM1, but turning stem cells into insulin producing factories promises treatment that is less invasive and possibly more effective.


ESSC
The scientists, working at Yale School of Medicine, harvested so called adult stem cells from the endometrium of female mice. Normally, these cells are responsible of renewing the cellular lining in the uterus wall. While these cells, called ESSC, are stem cells, they are in fact quite specialized: they differ from the embryonic stem cells that are often presented in the media as the wonder cure for everything. ESSC are specialized towards becoming endometrial cells, but have retained their capability to change their cellular lineage, and differentiate into something completely different. At Yale, the scientists used a cocktail of factors that promote differentiation into insulin producing cells. They did not need to modify the cells genetically, which is fairly often performed to direct adult stem cells into a different lineage. This is highly advantageous, as genetic modification possesses a higher risk and is therefore less suitable when designing a new therapy.

Experiments
Both in vitro and in vivo testing showed the efficacy of the modified ESSC. The scientists assessed expression of markers that are typically produced by ß-cells, and found that they were upregulated in differentiated ESSC, compared to ESSC that were left untouched. Also, the differentiated ESSC produce insulin. Thereafter, using the differentiated ESSC in a murine model showed that diabetic mice receiving treatment restored their glucose levels over the course of 5 weeks. Control mice, however, developed a pathological high level of glucose in the blood, known as hyperglycaemia. Additionally, the control mice developed typical DM1 symptoms such as cataract.

Advantages
The perks of using endometrial stem cells, compared to other novel forms of treatment, such as islet transplantation, are that the ESSC provide a renewable and easily accessable source of cells. More importantly perhaps, is that the cells are derived from the patient's own body. This eliminates immunological incompatbility, which would otherwise destroy therapeutic cells, and renders immunosuppression unnecessary. This way, the patient's immune system can be left intact, which reduces risk of acquiring infections due to an insufficient immune response.

Insulin production
The stem cell therapy will not work for patients suffering from Diabetes Mellitus type 2 (DM2). Patients with DM2 do produce insulin, however, their cells have become less responsive towards the hormone, causing pathologically high blood glucose levels. Of course, the use of ESSC has only been tested in mice, which means that their efficacy in human patients is not known. But the relative ease at which the Yale scientists seem to able to induce insulin producing cells is promising. Our current knowledge about modifying either embryonic stem cells, or adult stem cells already committed to a specific cellular lining, makes restoring tissues such as the ß-cell islets in DM1 something that might well be possible in humans in the near future.