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Diabetes-free Donors are Best Source of Stem Cells for Bone Repair in Type 1 Patients

Durham, NC – A groundbreaking study released today in STEM CELLS Translational Medicine shows that the  gold standard for obtaining stem cells to use in transplantation therapy – harvesting them from the patient himself – is not the best way to go when attempting to regenerate bone in a person with type 1 diabetes.

Type 1 diabetes is linked to low bone density, which greatly increases the risk of fractures. Researchers don’t know exactly why — it might be that insulin, which is deficient in the disease, promotes bone growth and strength – but all agree that finding a way to address this issue is important.

While stem cell-derived exosomes have exhibited promise for bone regeneration, identifying an appropriate source to obtain them has proven difficult. Yimin Chai, M.D., Ph.D., and his team at Shanghai Jiao Tong University Affiliated Sixth People’s Hospital have been researching this issue for some time. Their earlier studies revealed that exosomes (which are basically “taxis” that shuttle proteins and genetic information between cells) derived from different cell types exhibit different therapeutic effects. “It is therefore critical to carefully consider the biological characteristics of the cell of origin and use the appropriate source cells for therapeutic purposes,” Dr. Chai said.

As bone regeneration is a complex process with overlapping phases in which bone marrow mesenchymal stem cells (BMSCs) play a central role, the Chai team wanted to learn how exosomes secreted by BMSCs derived from type 1 diabetes rats (dBMSC-exos) measured up to those derived from normal rats (nBMSC-exos).

This is the first time such a comparison has been made.

“Our study indicated that both the nBMSC-exos and the dBMSC-exos had some regenerative effect, but the cells derived from the healthy animals were far more potent than those from the rats with diabetes,” Dr. Chai reported. “We think this is because the components present in the BMSC-exos may have changed as a result of the diabetes.”

Their findings are of great significance for the future clinical translation of BMSC-exos-based therapies, the team believes. “Considering that patients with diabetes are more susceptible to impaired bone healing and osteonecrosis, there is a compelling need to develop bone reparative strategies specifically targeting this population of patients,” said lead investigator Yu Zhu, Ph.D. The next step will be to repeat the study using cells derived from humans.

“These findings reveal that autologous transplantation of BMSCs may be inadequate for the diabetes mellitus population and provide new understanding that can be applied toward the future clinical translation of bone reparative strategies,” said Anthony Atala, M.D., Editor-in-Chief of STEM CELLS Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine. “We look forward to seeing the successful advancement of this work.”


The full article, “Impaired bone regenerative effect of exosomes derived from bone marrow mesenchymal stem cells in type 1 diabetes,” can be accessed at

About STEM CELLS Translational Medicine: STEM CELLS Translational Medicine (SCTM), co-published by AlphaMed Press and Wiley, is a monthly peer-reviewed publication dedicated to significantly advancing the clinical utilization of stem cell molecular and cellular biology. By bridging stem cell research and clinical trials, SCTM will help move applications of these critical investigations closer to accepted best practices. SCTM is the official journal partner of Regenerative Medicine Foundation.

About AlphaMed Press: Established in 1983, AlphaMed Press with offices in Durham, NC, San Francisco, CA, and Belfast, Northern Ireland, publishes two other internationally renowned peer-reviewed journals: STEM CELLS® (, celebrating its 37th year, is the world's first journal devoted to this fast paced field of research.  The Oncologist® (, also a monthly peer-reviewed publication, entering its 24th year, is devoted to community and hospital-based oncologists and physicians entrusted with cancer patient care. All three journals are premier periodicals with globally recognized editorial boards dedicated to advancing knowledge and education in their focused disciplines. 

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About Regenerative Medicine Foundation (RMF): The non-profit Regenerative Medicine Foundation fosters strategic collaborations to accelerate the development of regenerative medicine to improve health and deliver cures. RMF pursues its mission by producing its flagship World Stem Cell Summit, honouring leaders through the Stem Cell and Regenerative Medicine Action Awards, and promoting educational initiatives.