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Treatment of diabetes and cardiovascular diseases by Regenerative Medicine

Ghorbani Ahmad

The increased incidence of chronic metabolic disorders, including diabetes and cardiovascular diseases, has become one of the worldwide health challenges of the 21st century.

Despite extensive effort in the past years to develop new therapeutics, currently available drugs failed to cure these diseases. For example, many diabetic patients in the advanced stage may need organ transplantation because of developing life-threatening complications such as nephropathy and heart failure. However, transplantation therapy is restricted by organ availability and immune reactions, indicating the importance of need for stem cells therapy and tissue regenerative approaches. Nowadays, substantial progress has been made in cell therapy technologies. In spite of this, several challenges remain to be resolved to achieve more effective therapy. Some of these challenges include: insufficient amount of stem cells that can be obtained from tissues; inadequate migration and homing of exogenous stem cells; limited differentia A growing body of evidence suggests that pharmacological manipulation can help to overcoming these challenges and improve the preclinical and clinical utility of regenerative medicine technologies. This review focuses on studies performed by our research group and others to enhance proliferation, survival, migration, homing, and differentiation potential of stem cells by application of pharmacological sciences. Historically, small molecule (i.e., compounds of <500–800 mol. wt.) pharmaceutical research and development has focused on compounds with increasingly selective mechanisms of action. This makes sense from a symptom-based approach to the treatment of disease, wherein one wishes to focus on the primary mechanism of action required for drug efficacy while simultaneously limiting off-target effects and minimizing adverse events/side effects. The development requirements for regenerative pharmacology will be much more demanding. In fact, the challenges associated with regenerative pharmacology, that is, curative therapeutics, will in many instances require complex mixtures of compounds [i.e., growth factors such as fibroblast growth factor (FGF), epidermal growth factor (EGF), platelet-derived growth factor, nerve growth factor (NGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF), bone morphogenic proteins (BMPs), etc.] for restoration of tissue/organ function. These latter compounds have significantly higher molecular weights (generally ≈10,000 to >100,000 mol. wt.) than those traditionally developed by the pharmaceutical industry. tion potential of stem cells under in vivo situation; and decease of stem cells in damaged tissue.