Title:Bone Marrow as a Therapeutic Target for Type 2 Diabetes Complications
Volume: 23
Issue: 13
Author(s): Saúl Ernesto Cifuentes-Mendiola, Luis Arturo Baiza-Gutman*Ana Lilia García-Hernández
Affiliation:
- Faculty of Higher Studies-Iztacala, Laboratory
of Developmental Biology, National Autonomous University of Mexico, Tlalnepantla, Estado de México, México
Keywords:
Type 2 diabetes, bone marrow, cardiovascular disease, diabetic nephropathy, bone fragility, stem cells, therapeutic strategies.
Abstract: Type 2 diabetes mellitus (T2DM) is a world epidemic with a high prevalence and mortality.
The origin of macro and microvascular complications associated with T2DM is complex and
new mechanisms to explain their development are emerging. The changes induced by T2DM in
the microenvironment of bone marrow (BM) alter the expansion and differentiation of stem cells
and have been related to the development of micro and macrovascular diseases. Alterations in the
differentiation and function of hematopoietic, endothelial, and mesenchymal stem cells in T2DM
patients reduced the mobility of BM stem cells to the circulation and some immature, dysfunctional,
or inflammatory cells pass to the blood (mobilopathy). Consequently, tissue repair is impaired,
and the tissue damage caused by hyperglycemia, oxidative stress, and inflammation is increased.
These alterations can contribute to diabetic complications, decreasing the quality of life,
and increasing mortality. The modulation of the bone marrow microenvironment may be a therapeutic
target for treating T2DM and its complications. This article analyses the changes induced in BM
and their impact on the development of cardiovascular and kidney complications in T2DM. Also,
different therapeutic strategies to restore the bone marrow microenvironment and function through
the modulation of oxidative stress, inflammation, and adipogenicity are discussed, considering
bone marrow as a novel potential therapeutic target to treat vascular complications of diabetes.