利用动物模型研究糖尿病的干细胞疗法。

The use of animal models to study stem cell therapies for diabetes mellitus.

作者信息

Song Woo-Jin, Shah Rohan, Hussain Mehboob A

机构信息

Metabolism Division, Department of Pediatrics, Johns Hopkins University, Baltimore, MD 21287, USA.

出版信息

ILAR J. 2009;51(1):74-81. doi: 10.1093/ilar.51.1.74.

Abstract

The two main forms of human diabetes mellitus (DM) are characterized by an absolute (type 1) and a relative (type 2) reduction in functional insulin-producing beta cell mass in the pancreas. Type 1 DM results from autoimmune assault of beta cells, and type 2 from the failure of pancreatic beta cells to sufficiently compensate for insulin resistance. Studies indicate that the incidence of both types is increasing rapidly to levels that constitute a global epidemic. Researchers are experimentally developing several conceptual approaches for increasing pancreatic beta cell mass and testing them for feasibility in treating the disease. The main sources for derivation of insulin-producing cells are embryonic and induced pluripotent stem cells, endogenous progenitor cells (both within and outside the pancreas), stimulation of beta cell proliferation, and genetic "reprogramming" of cells. Strategies to effectively address immune- and inflammation-mediated assault on existing and newly formed beta cells need to be refined. This review provides a description of beta cell ablation methods and a discussion of various types of studies of regenerative approaches-beta cell proliferation, islet cell transplantation, transdifferentiation, and the use of embryonic and induced pluripotent stem cells-to the treatment of diabetes mellitus. Although there has been much progress in this area, further research is needed to enhance understanding and improve therapeutic strategies for this widespread disease.

摘要

人类糖尿病(DM)的两种主要形式的特征是胰腺中产生功能性胰岛素的β细胞数量绝对(1型)和相对(2型)减少。1型糖尿病是由β细胞的自身免疫攻击引起的,2型糖尿病则是由于胰腺β细胞无法充分补偿胰岛素抵抗所致。研究表明,这两种类型的发病率都在迅速上升,达到了全球流行的程度。研究人员正在通过实验开发几种增加胰腺β细胞数量的概念性方法,并对其治疗该疾病的可行性进行测试。产生胰岛素的细胞的主要来源是胚胎干细胞和诱导多能干细胞、内源性祖细胞(胰腺内外)、刺激β细胞增殖以及细胞的基因“重编程”。有效应对免疫和炎症介导的对现有和新形成的β细胞的攻击的策略需要进一步完善。本综述描述了β细胞消融方法,并讨论了各种类型的再生方法研究——β细胞增殖、胰岛细胞移植、转分化以及胚胎干细胞和诱导多能干细胞在糖尿病治疗中的应用。尽管该领域已经取得了很大进展,但仍需要进一步研究,以加深对这种广泛疾病的理解并改进治疗策略。

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