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Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes

  • Authors:
    • Siufui Hendrawan
    • Jennifer Lheman
    • Olivia Marcelina
    • Lydia Tantoso
    • Hans Ulrich Baer
    • Shirly Gunawan
  • View Affiliations / Copyright

    Affiliations: Department of Biochemistry and Molecular Biology, Faculty of Medicine, Tarumanagara University, Jakarta 11440, Indonesia, Tarumanagara Human Cell Technology Laboratory, Faculty of Medicine, Tarumanagara University, Jakarta 11440, Indonesia, Department of Internal Medicine, Faculty of Medicine, Tarumanagara University, Jakarta 11440, Indonesia, Baermed, Center of Abdominal Surgery, Hirslanden Clinic, 8032 Zürich, Switzerland, Department of Visceral and Transplantation Surgery, University of Bern, 3012 Bern, Switzerland
    Copyright: © Hendrawan et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 116
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    Published online on: October 6, 2025
       https://doi.org/10.3892/wasj.2025.404
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Abstract

Standard therapies for type 2 diabetes (T2DM) that utilize anti‑diabetic drugs and insulin are well established; nevertheless, the incidence of complications and mortality associated with the disease remain relatively high. Conditioned medium (CM) from human umbilical cord‑derived mesenchymal stem cells (hUC‑MSCs) has demonstrated regenerative effects, although these have yet to be properly investigated for the purposes of managing T2DM. Therefore, the present study aimed to evaluate the therapeutic potential of CM from hUC‑MSCs in various animal models of T2DM. T2DM was established in rats using a high‑fat diet and streptozotocin, and the rats were subsequently injected with insulin, CM or insulin + CM two times per week (subcutaneously for insulin; intraperitoneally for CM) over a 4‑week period. Blood glucose levels were measured prior to each treatment up until 2 weeks after the final injection. At the end of the experiment, glucose tolerance, insulin sensitivity and the levels of glycated hemoglobin (HbA1c), serum insulin and insulin‑like growth factor‑1 (IGF‑1) were measured. Histological analyses of pancreatic tissues were also performed, and the findings were compared among the groups. The CM‑treated group was found to exhibit significantly improved levels of blood glucose, glucose tolerance and insulin sensitivity, whereas administering a combination of CM and insulin therapy to the rats led to even more robust effects in terms of blood glucose level management and reducing the level of HbA1c compared with the other treatment groups. CM treatment also led to an improvement in the IGF‑1 serum level, although this was found to be reduced in the other diabetic groups. Furthermore, both the numbers of β‑cells and their capability to secrete insulin were enhanced in the CM‑treated group. Taken together, these findings underscore the regenerative effect of CM from hUC‑MSCs in terms of T2DM therapy.
View Figures

Figure 1

Standard feed and HFD feed. 1, 100%
standard feed; 2, 75% standard feed:25% HFD; 3, 50% standard
feed:50% HFD; 4, 25% standard feed:75% HFD; 5, 100% HFD. HFD,
high-fat diet.

Figure 2

Schematic diagram of type 2 diabetes
animal model development. STZ, streptozotocin; FBG, fasting blood
glucose; BW, body weight.

Figure 3

Administration of treatments
according to the study groups. (A) Subcutaneous administration of
insulin and (B) intraperitoneal injection of serum-free media or
conditioned medium.

Figure 4

CM positively regulated blood glucose
levels in rats with diabetes. Comparison of (A) fasting blood
glucose levels, (B) HbA1c, (C) fasting serum insulin level, and (D)
insulin resistance index between groups. HFD indicates the starting
point of HFD feed; Pre-STZ represents 4 weeks post-HFD and before
the STZ injection; Post-STZ represents diabetes confirmation; W1-W4
represents weeks 1-4 of treatment; W5-W6 represents weeks 5-6 (2
weeks after the final treatment). Data are expressed as the mean ±
SD (n=5/group). #P<0.05, significant difference
compared to the DM + insulin group, **P<0.01 and
***P<0.001, significant difference compared to the
normal group (P-values are indicated above the bars); NS, not
significant. Statistical analysis was determined using (A) repeated
measures ANOVA and (B-D) one-way ANOVA. DM, diabetes mellitus; CM,
conditioned medium; HFD, high-fat diet; HbA1c, glycated
hemoglobin.

Figure 5

The glucose tolerance test and
insulin sensitivity test. (A) OGTT of each group was determined at
0, 30, 60, 90 and 120 min post-glucose administration. (B) Area
under the curve of OGTT. (C) IPITT of each group was determined at
0, 30, 60, 90 and 120 min post-insulin administration. (D) Area
under the curve of IPITT. Data are expressed as the mean ± SD
(n=5/group). *P<0.05, **P<0.01 and
***P<0.001, significant difference compared to the
normal group (P-values are indicated above the bars); NS, not
significant. Statistical analysis was determined using (A and C)
repeated measures ANOVA and (B and D) one-way ANOVA. OGTT, oral
glucose tolerance test; IPITT, intraperitoneal insulin tolerance
test; DM, diabetes mellitus; CM, conditioned medium.

Figure 6

Measurement of serum IGF-1 and
hepatic TNF-α protein levels. (A) Serum IGF-1 and (B) hepatic TNF-α
protein levels were measured at the study endpoint using ELISA.
Data are expressed as the mean ± SD (n=5/group).
*P<0.05, compared to the normal group (P-values are
indicated above the bars); #P<0.05, compared between
indicated groups; NS, not significant. Statistical analysis was
performed using one-way ANOVA. IGF-1, insulin growth factor-1;
TNF-α, tumor necrosis factor-α; DM, diabetes mellitus; CM,
conditioned medium.

Figure 7

Histopathological analysis of islets
of Langerhans on pancreatic tissue section stained with H&E and
Gomori staining, and IHC for insulin. β-cells are represented as a
dark blue color (yellow arrows) and insulin-positive cells are
represented as brown colorization (red arrows). Magnification: x200
for H&E staining, and x400 for Gomori staining and IHC. Scale
bars, 50 µm. H&E, hematoxylin and eosin. IHC,
immunohistochemistry; DM, diabetes mellitus; CM, conditioned
medium.
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Copy and paste a formatted citation
Spandidos Publications style
Hendrawan S, Lheman J, Marcelina O, Tantoso L, Baer HU and Gunawan S: Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes. World Acad Sci J 7: 116, 2025.
APA
Hendrawan, S., Lheman, J., Marcelina, O., Tantoso, L., Baer, H.U., & Gunawan, S. (2025). Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes. World Academy of Sciences Journal, 7, 116. https://doi.org/10.3892/wasj.2025.404
MLA
Hendrawan, S., Lheman, J., Marcelina, O., Tantoso, L., Baer, H. U., Gunawan, S."Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes". World Academy of Sciences Journal 7.6 (2025): 116.
Chicago
Hendrawan, S., Lheman, J., Marcelina, O., Tantoso, L., Baer, H. U., Gunawan, S."Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes". World Academy of Sciences Journal 7, no. 6 (2025): 116. https://doi.org/10.3892/wasj.2025.404
Copy and paste a formatted citation
x
Spandidos Publications style
Hendrawan S, Lheman J, Marcelina O, Tantoso L, Baer HU and Gunawan S: Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes. World Acad Sci J 7: 116, 2025.
APA
Hendrawan, S., Lheman, J., Marcelina, O., Tantoso, L., Baer, H.U., & Gunawan, S. (2025). Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes. World Academy of Sciences Journal, 7, 116. https://doi.org/10.3892/wasj.2025.404
MLA
Hendrawan, S., Lheman, J., Marcelina, O., Tantoso, L., Baer, H. U., Gunawan, S."Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes". World Academy of Sciences Journal 7.6 (2025): 116.
Chicago
Hendrawan, S., Lheman, J., Marcelina, O., Tantoso, L., Baer, H. U., Gunawan, S."Regenerative therapeutic effects of conditioned medium from human umbilical cord‑derived mesenchymal stem cells as an adjuvant to insulin therapy in a rat model of type 2 diabetes". World Academy of Sciences Journal 7, no. 6 (2025): 116. https://doi.org/10.3892/wasj.2025.404
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