Potential treatment for neural, muscular complications of diabetes
doi:10.1038/nindia.2021.21 Published online 5 February 2021
Researchers at the Indian Institute of Technology Kanpur (IITK) have developed in rat models potential treatments for diabetic foot ulcer (DFU) and diabetic peripheral neuropathy (DPN) – two major complications associated with diabetes. The work assumes importance as India is set to become the ‘diabetes capital of the world’ with a projected 109 million cases by 2035.
DPN that leads to severe nerve damage has no effective treatment. It has been challenging for scientists to regenerate nerve fibres and achieve functionality after neuropathy, a nerve dysfunction that results in numbness, tingling, muscle weakness and pain. To treat this, the IITK researchers have combined biochemical and electrical cues, considered important for nerve regeneration.
They used exosomes derived from Bone Marrow Mesenchymal Stromal Cells (BMSCs) and liposomes, tiny spherical sacs of lipid molecules that can act as carriers for drug delivery. Exosomes, which are tiny vesicles containing various biomolecules have been used as nanocarriers due to their ability to cross the blood-brain barrier. Exosomes derived from BMSCs contain microRNAs and proteins which improve the functional recovery of the nerves.
The researchers fused these exosomes with liposomes containing conducting polymers called polypyrrole nanoparticles (PpyNps) and injected this fused exosomal system intramuscularly into rats with DPN.
The idea was to make this system work synergistically – biochemical cues from the exosomes would help regenerate nerves after DPN, and electrical cues from the polymers along with external electrical stimulation would lead to nerve repair and regeneration. The researchers found that the combined effect of the fused exosomes and short duration electrical stimulation regenerated nerves in 6 to 8 weeks in the rats.
“Interestingly, this therapy controlled the diabetic hyperglycemia and also regenerated other effected tissues such as liver, pancreas and kidney,” Ashok Kumar, professor of bioengineering at IITK, told Nature India.
The researchers are now awaiting approvals for controlled clinical trials of a combined therapy targeted at mitigating both DPN and DFU. “If successful, this could be a new and advanced therapy for suffering patients.”
1. Singh, A. et al. Transplantation of engineered exosomes derived from bone marrow mesenchymal stromal cells ameliorate diabetic peripheral neuropathy under electrical stimulation. Bioactive Mater. 6, 2231-2249 (2021) doi: 10.1016/j.bioactmat.2021.01.008