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Minerva Biotecnologica 2006 June;18(2):77-88

Copyright © 2006 EDIZIONI MINERVA MEDICA

lingua: Inglese

Stem cells and islet engineering for cell replacement therapy in diabetes

Montanya E.

Endocrinology Unit, Department of Clinical Sciences Bellvitge University Hospital, University of Barcelona IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain

The dramatic imbalance between the scarcity of islet tissue available for transplantation and the number of potential recipients is a major obstacle for cell replacement therapy to become a widely used treatment of diabetes. This review is focused on the strategies aiming to generate unlimited amounts of insulin producing cells for transplantation in diabetic patients, in particular, the ex vivo expansion of human islets, the engineering of insulin-producing cells, and the differentiation of embryonic or adult stem cells into insulin-producing cells. The engineering of transformed b-cell lines of murine or human origin, and of non b-cells has progressed slowly in past years, but an immortalized human b-cell line has just been generated. Significant advances have been achieved in the generation of insulin producing cells from embryonic stem cells, and from adult stem/progenitor cells of both pancreatic and extrapancreatic origin even though no fully defined adult b-cell stem/progenitor cell has yet been characterized. In parallel, the limitations of current knowledge have become more evident, and the critical assessment of some of the achievements has lead to a better appreciation of the challenges that lay ahead. In particular, it is clear that the so far generated insulin-positive cells do not meet the criteria that characterize mature b-cells. Thus, a promising array of possibilities has emerged in recent years, but their fulfillment will require a much better understanding of the processes that govern the generation of b-cells.