Imaging in Stem Cell Transplant and Cell-based Therapy

63

ejection fraction at 6 months, thus lending support to the theory that mesenchymal
stem cells promote remodeling of the left ventricle [ 41 ].
In a more recent study, 53 patients with first episode of myocardial infarction
who were treated with intravenous mesenchymal stem cells vs placebo showed
improved outcomes related to cardiac arrhythmias, pulmonary function, left ven-
tricular function and symptomatic global assessment compared to placebo treated
patients. Significant improvement in left ventricular ejection fraction as quantified
by cardiac MRI was seen in the treated group and was maintained at 12 month fol-
low up [ 42 ].

4.7 Endocrine Diseases

4.7.1 Type 1 Diabetes Mellitus

Type 1 diabetes mellitus is a chronic debilitating condition triggered by autoim-
mune mediated destruction of insulin producing pancreatic beta cells by activated T
lymphocytes. In addition to life long insulin requirement, islet cell transplantation is
one of the more definitive treatment options that has been tried. One of the first Islet
cell transplantation techniques in six insulin dependent diabetic patients using tran-
shepatic intra portal infusion was described by Neeman et  al. using six patients,
with improved glycemic control and lesser need for insulin following islet cell
transplantation. Since then several studies have also described other routes and tech-
niques to perform Islet cell transplantation. However, the limited supply of islet
cells and adverse effects of life long immunosuppression have necessitated the use
of safer alternatives such as use of stem cells [ 43 ].
Mesenchymal stem cells due to their immune-modulatory properties may have a
role in inhibiting the function of T-lymphocytes which cause destruction of newly
formed beta cells. Also due to their trophic and angiogenic properties, mesenchymal

Infarcted

myocardium

Injection of stem

cells

Improved LV

function and

remodeling

a

Fig. 4.7 Role of stem cells
in myocardial infarction
(arrow)

4 Clinical Applications of Stem Cell Transplant in Treating Non-Hematologic...