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Histological Study on the Effects of Allogenic Bone Marrow Derived Mesenchymal Stem Cells Along with Local Insulin Therapy on Osteosynthesis in Gap Defects of Radius in Diabetic Rabbit Model

Background: Diabetes mellitus impairs fracture healing causing bone repair abnormality which is insulin dependent. Exogenous insulin can accelerate fracture healing in diabetes by promoting bone remodeling and bone formation. Mesenchymal stem cell loaded scaffolds having osteoinductive and osteoconductive properties, may be used as an alternative for autogenous bone grafting. The current study aimed to investigate the efficacy of cultured allogenic bone marrow derived mesenchymal stem cell implantation with insulin therapy for increasing osteosynthesis in bone gap defects in experimentally induced diabetic rabbits.
 Methods: Thirty six, New Zealand White rabbits were divided into four groups: A, B, C and D. Diabetes was induced experimentally in all rabbits, except group A. A 5 mm bone defect was created in right radii of all rabbits and following treatment was given: hydroxyapatite granules (group A and B), hydroxyapatite granules and insulin therapy (group C), cultured allogenic BMMSCs in hydroxyapatite scaffold and insulin therapy (group D). Histologic evaluation was performed on days 30, 60 and 90.
 Result: Combined therapy of allogenic BMMSCs in hydroxyapatite scaffold along with local insulin (group D) provided best healing response followed by healthy control (group A), locally insulin treated group (group C) and diabetic control (group B).