Combination of Sleeve Gastrectomy and Mesenchymal Stem Cells Improves Insulin Resistance by Modulating Pro-inflammatory Milieu in Obese Type 2 Diabetic Rat Model

Background: Obesity is a major risk factor for the onset of insulin resistance and type 2 diabetes mellitus (T2DM) caused by chronic inflammation of the islets of langerhans. Sleeve gastrectomy (SG) procedure increases particular hormone which stimulates insulin sensitivity. Mesenchymal stem cells (MSCs) can also exhibit potential immunomodulatory properties through their paracrine effects, however the mechanism regarding combination of them could not be adequately explained. Aim: In this study, we explore the potential of sleeve gastrectomy followed by injection of MSCs in type 2 diabetic rats with obesity in improving insulin resistance. Methods: This study used a pre and post control group design with 18 rats that divided into 3 groups: control (C), sleeve gastrectomy (SG), sleeve gastrectomy + MSCs (SG+M). On day 10, the level of IL-6, IL-10 and HOMA-IR were evaluated using ELISA. Results: This study showed a significant decrease of IL-6 level in all treatment groups on day 10, in which SG+M group showed optimum inhibition. This result was in line with the optimum increase of IL-10 in SG+M group. Moreover, our study also revealed the optimum decrease of HOMA-IR in SG+M group on day 10. Conclusion: Combination of SG and MSCs can optimally improve insulin resistance by modulating proinflammatory milieu though inhibiting IL-6 level and upregulating IL-10 level in obese type 2 diabetes mellitus rat model.