Tuch B E, Szymanska B, Yao M, Tabiin M T, Gross D J, Holman S, Swan M Anne, Humphrey R K B, Marshall G M, Simpson A M
Diabetes Transplant Unit, Prince of Wales Hospital and The University of New South Wales, Sydney, Australia.
Gene Ther. 2003 Mar;10(6):490-503. doi: 10.1038/sj.gt.3301911.
An alternative approach to the treatment of type I diabetes is the use of genetically altered neoplastic liver cells to synthesize, store and secrete insulin. To try and achieve this goal we modified a human liver cell line, HUH7, by transfecting it with human insulin cDNA under the control of the cytomegalovirus promoter. The HUH7-ins cells created were able to synthesize insulin in a similar manner to that which occurs in pancreatic beta cells. They secreted insulin in a regulated manner in response to glucose, calcium and theophylline, the dose-response curve for glucose being near-physiological. Perifusion studies showed that secretion was rapid and tightly controlled. Removal of calcium resulted in loss of glucose stimulation while addition of brefeldin A resulted in a 30% diminution of effect, indicating that constitutive release of insulin occurred to a small extent. Insulin was stored in granules within the cytoplasm. When transplanted into diabetic immunoincompetent mice, the cells synthesized, processed, stored and secreted diarginyl insulin in a rapid regulated manner in response to glucose. Constitutive release of insulin also occurred and was greater than regulated secretion. Blood glucose levels of the mice were normalized but ultimately became subnormal due to continued proliferation of cells. Examination of the HUH7-ins cells as well as the parent cell line for beta cell transcription factors showed the presence of NeuroD but not PDX-1. PC1 and PC2 were also present in both cell types. Thus, the parent HUH7 cell line possessed a number of endocrine pancreatic features that reflect the common endodermal ancestry of liver and pancreas, perhaps as a result of ontogenetic regression of the neoplastic liver cell from which the line was derived. Introduction of the insulin gene under the control of the CMV promoter induced changes in these cells to make them function to some extent like pancreatic beta cells. Our results support the view that neoplastic liver cells can be induced to become substitute pancreatic beta cells and become a therapy for the treatment of type I diabetes.
治疗I型糖尿病的另一种方法是利用基因改造的肿瘤肝细胞来合成、储存和分泌胰岛素。为了尝试实现这一目标,我们通过在巨细胞病毒启动子的控制下用人类胰岛素cDNA转染人类肝细胞系HUH7对其进行了改造。所产生的HUH7-ins细胞能够以与胰腺β细胞类似的方式合成胰岛素。它们在葡萄糖、钙和茶碱的刺激下以一种受调节的方式分泌胰岛素,葡萄糖的剂量反应曲线接近生理状态。灌流研究表明分泌迅速且受到严格控制。去除钙会导致葡萄糖刺激作用丧失,而添加布雷菲德菌素A会使作用减弱30%,这表明胰岛素存在一定程度的组成型释放。胰岛素储存在细胞质内的颗粒中。当将这些细胞移植到无免疫能力的糖尿病小鼠体内时,细胞会根据葡萄糖迅速以受调节的方式合成、加工、储存和分泌双精氨酸胰岛素。胰岛素也会发生组成型释放,且大于受调节的分泌。小鼠的血糖水平恢复正常,但最终由于细胞持续增殖而变得低于正常水平。对HUH7-ins细胞以及亲本细胞系进行β细胞转录因子检测发现存在NeuroD但不存在PDX-1。PC1和PC2在两种细胞类型中也都存在。因此,亲本HUH7细胞系具有许多内分泌胰腺特征,这反映了肝脏和胰腺共同的内胚层起源,这可能是该细胞系所源自的肿瘤肝细胞个体发育退化的结果。在CMV启动子控制下引入胰岛素基因诱导了这些细胞发生变化,使其在一定程度上发挥类似胰腺β细胞的功能。我们的结果支持这样一种观点,即肿瘤肝细胞可被诱导成为替代胰腺β细胞,并成为治疗I型糖尿病的一种疗法。