PELUANG DAN TANTANGAN TERAPI REGENERATIF DENGAN STEM CELL DALAM PENANGANAN DIABETES TIPE 1

Karen Bernadette; Syaifun Niam

doi:10.31004/prepotif.v9i1.44147

Authors

Karen Bernadette Fakultas Kedokteran Universitas Tarumanagara, Jakarta, Indonesia
Syaifun Niam Departemen Ilmu Penyakit Dalam RSD K.R.M.T. Wongsonegoro, Semarang, Indonesia

DOI:

https://doi.org/10.31004/prepotif.v9i1.44147

Keywords:

diabetes tipe 1, diferensiasi, reaksi imun, sel beta pankreas, stem cell, terapi regeneratif

Abstract

Diabetes melitus tipe 1 (T1DM) adalah kondisi autoimun yang merusak sel beta pankreas, menyebabkan ketergantungan pada insulin eksogen. Meskipun terapi insulin mengendalikan kadar glukosa, komplikasi jangka panjang tetap menjadi masalah. Terapi regeneratif dengan stem cell berpotensi menggantikan sel beta yang rusak dan mengembalikan kemampuan tubuh untuk memproduksi insulin secara alami. Namun, tantangan besar yang dihadapi adalah proses diferensiasi stem cell menjadi sel beta pankreas yang fungsional, reaksi imun terhadap sel transplantasi, dan pemilihan sumber stem cell yang tepat. Penelitian ini bertujuan untuk mengevaluasi peluang dan tantangan dalam pengembangan terapi stem cell untuk T1DM, dengan fokus pada mekanisme diferensiasi, risiko, dan hambatan dalam penerapan terapi ini. Hasil kajian menunjukkan bahwa mesenchymal stem cells (MSC) dan pluripotent stem cells (PSC) memiliki potensi untuk regenerasi sel beta, meskipun tantangan seperti efisiensi diferensiasi dan integrasi sel dalam pankreas masih perlu diatasi. Terapi stem cell ini berpotensi menjadi solusi dalam pengobatan T1DM jika teknologi dan pemahaman lebih lanjut dapat dikembangkan.

References

Banerjee, Souradeep & Nara, Ritika & Chakraborty, Soham & Chowdhury, Debojyoti & Haldar, Shubhasis. (2022). Integrin Regulated Autoimmune Disorders: Understanding the Role of Mechanical Force in Autoimmunity. Frontiers in Cell and Developmental Biology. 10. 852878. 10.3389/fcell.2022.852878.

Carlsson PO, Espes D, Sisay S, Davies LC, Smith CIE, Svahn MG. Umbilical cord-derived mesenchymal stromal cells preserve endogenous insulin production in type1 diabetes: a phase I/II randomised double-blind placebo-controlled trial. Diabetologia. 2023.

Chen, Shuai et al. “Current progress in stem cell therapy for type 1 diabetes mellitus.” Stem cell research & therapyvol. 11,1 275. 8 Jul. 2020, doi:10.1186/s13287-020-01793-

Gao, S., Zhang, Y., Liang, K., Bi, R., & Du, Y. (2022). Mesenchymal stem cells (MSCs): a novel therapy for type 2 diabetes. Stem Cells International, 2022.

Ghoneim, M.A., Gabr, M.M., El-Halawani, S.M. et al. Current status of stem cell therapy for type 1 diabetes: a critique and a prospective consideration. Stem Cell Res Ther 15, 23 (2024). https://doi.org/10.1186/s13287-024-03636-0

Ghoneim, M. A., Refaie, A. F., Elbassiouny, B. L., Gabr, M. M., & Zakaria, M. M. (2020). From mesenchymal stromal/stem cells to insulin-producing cells: progress and challenges. Stem Cell Reviews and Reports, 16, 1156�1172.

Gomzikova, M. O., James, V., & Rizvanov, A. A. (2021). Mitochondria donation by mesenchymal stem cells: current understanding and mitochondria transplantation strategies. Frontiers in Cell and Developmental Biology, 9, 653322.

He J, Kong D, Yang Z, Guo R, Amponsah AE, Feng B, et al. Clinical efficacy on glycemic control and safety of mesenchymal stem cells in patients with diabetes mellitus: systematic review and meta-analysis of RCT data. PLoS ONE. 2021;16:e0247662. https://doi.org/10.1371/journal.pone.0247662.

Izadi, Mahmoud et al. “Mesenchymal stem cell transplantation in newly diagnosed type-1 diabetes patients: a phase I/II randomized placebo-controlled clinical trial.” Stem cell research & therapyvol. 13,1 264. 20 Jun. 2022, doi:10.1186/s13287-022-02941-w

Jarrige, Margot et al. “The Future of Regenerative Medicine: Cell Therapy Using Pluripotent Stem Cells and Acellular Therapies Based on Extracellular Vesicles.” Cells vol. 10,2 240. 27 Jan. 2021, doi:10.3390/cells10020240

Jawale, Sagar. “Intrapancreatic autologous stem cell therapy for type 1 diabetes - an experimental study.” Annals of medicine and surgery (2012)vol. 85,9 4355-4371. 28 Jul. 2023, doi:10.1097/MS9.000000000000083

KEMENKES RI. 2024. Saatnya Mengatur Si Manis. Diakses pada 11 Desember 2024

Mesples, Alejandro D et al. “Monitoring of Autoantibodies Following Autologous Hematopoietic Stem Cell Transplantation in 6 Children with Recently Diagnosed Type 1 Diabetes Mellitus.” Medical science monitor : international medical journal of experimental and clinical research vol. 29 e938979. 20 Jan. 2023, doi:10.12659/MSM.93897

Rodrigues Oliveira, Sonia M et al. “Type 1 Diabetes Mellitus: A Review on Advances and Challenges in Creating Insulin Producing Devices.” Micromachines vol. 14,1 151. 6 Jan. 2023, doi:10.3390/mi1401015

Silva IBB, Kimura CH, Colantoni VP, Sogayar MC. Correction: Stem cells differentiation into insulin-producing cells (IPCs): recent advances and current challenges. Stem Cell Res Ther. 2022;13:520. https://doi.org/10.1186/s13287-022-03206-2.

Tan, Lay Shuen et al. “Manufacturing clinical-grade human induced pluripotent stem cell-derived beta cells for diabetes treatment.” Cell proliferation vol. 55,8 (2022): e13232. doi:10.1111/cpr.13232

Thakkar, Simran & Chopra, Aditi & Nagendra, Lakshmi & Kalra, Sanjay & Bhattacharya, Saptarshi. (2023). Teplizumab in Type 1 Diabetes Mellitus: An Updated Review. touchREVIEWS in Endocrinology. 19. 7. 10.17925/EE.2023.19.2.7.

Zhao, Yong et al. “Increase in the Expression of Glucose Transporter 2 (GLUT2) on the Peripheral Blood Insulin-Producing Cells (PB-IPC) in Type 1 Diabetic Patients after Receiving Stem Cell Educator Therapy.” International journal of molecular sciences vol. 25,15 8337. 30 Jul. 2024, doi:10.3390/ijms25158337