Urbán S Veronika, Kiss Judit, Vas Virág, Kovács János, Uher Ferenc
Országos Gyógyintézeti Központ, Ossejt-biológia.
Orv Hetil. 2006 Apr 30;147(17):791-7.
Curative therapy for diabetes mellitus mainly implies replacement of missing insulin-producing pancreatic beta cells, with pancreas or islet-cell transplants. The limited supply currently available from cadaveric donor islets for transplantation, however, determines that researchers must explore alternative sources of graft material. Stem cells represent a promising solution to this problem, and current research is being aimed at the creation of islet-endocrine tissue from these undifferentiated cells. Both embryonic stem cells (derived from the inner cell mass of a blastocyst) and adult tissue stem cells (found in the postnatal organism) have been used to generate surrogate beta cells or otherwise restore beta cell functioning. Nevertheless, cell replacement therapies that are stem cell based will remain fiction rather than fact until we can efficiently and reproducibly ensure that stable, fully functional cells can be generated in vitro. It is also critical to ensure that any surrogate or regenerated beta cells have perfectly regulated insulin production, which is essential for physiological glucose homeostasis. As in every emerging field in biology, early reports seem confusing and conflicting. Therefore, discrepancies between different results need to be reconciled. In addition, encouraging studies in rodent models may ultimately set the stage for large-animal studies. In this review, the authors provide insight into research efforts to overcome existing hurdles for this promising therapy.
糖尿病的治疗性疗法主要意味着通过胰腺或胰岛细胞移植来替代缺失的产生胰岛素的胰腺β细胞。然而，目前可用于移植的尸体供体胰岛的供应有限，这决定了研究人员必须探索移植材料的替代来源。干细胞是解决这一问题的一个有前景的办法，目前的研究旨在从这些未分化细胞中创建胰岛内分泌组织。胚胎干细胞（源自囊胚的内细胞团）和成体组织干细胞（存在于出生后的生物体中）都已被用于生成替代β细胞或以其他方式恢复β细胞功能。然而，在我们能够高效且可重复地确保在体外生成稳定、功能完全的细胞之前，基于干细胞的细胞替代疗法仍将是虚构而非事实。确保任何替代或再生的β细胞具有完美调节的胰岛素分泌也至关重要，这对于生理葡萄糖稳态必不可少。如同生物学中的每个新兴领域一样，早期报告似乎令人困惑且相互矛盾。因此，需要调和不同结果之间的差异。此外，在啮齿动物模型中的鼓舞人心的研究最终可能为大型动物研究奠定基础。在这篇综述中，作者深入探讨了为克服这种有前景的疗法的现有障碍所做的研究努力。
