Haematology and BMT Unit, San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Cell Transplant. 2010;19(12):1511-22. doi: 10.3727/096368910X514279. Epub 2010 Aug 17.
In the past years, in the field of β-cell replacement for diabetes therapy, the easy availability of bone marrow (BM) and the widely consolidated clinical experience in the field of hematology have contributed to the development of strategy to achieve donor-specific transplantation tolerance. Recently, the potential role of BM in diabetes therapy has been reassessed from a different point of view. Diverse groups investigated the contribution of BM cells to β-cell replacement as direct differentiation into insulin-producing cells. More importantly, while direct differentiation is highly unlikely, a wide array of experimental evidences indicates that cells of BM origin are capable of facilitating the survival or the endogenous regeneration of β-cells through an as yet well-defined regeneration process. These new experimental in vitro and in vivo data will expand in the near future the clinical trials involving BM or BM-derived cells to cure both type 1 and type 2 diabetes in humans. In this review we recapitulate the history of use of BM in diabetes therapy and we provide clinically relevant actual information about the participation of BM and BM-derived stem cells in islet cell regeneration processes. Furthermore, new aspects such as employing BM as "feeder tissue" for pancreatic islets and new clinical use of BM in diabetes therapy are discussed.
在过去的几年中，在β细胞替代治疗糖尿病的领域中，骨髓（BM）的易得性和血液学领域广泛巩固的临床经验促进了实现供体特异性移植耐受的策略的发展。最近，人们从不同的角度重新评估了 BM 在糖尿病治疗中的潜在作用。不同的研究小组研究了 BM 细胞作为直接分化为产生胰岛素的细胞对β细胞替代的贡献。更重要的是，虽然直接分化的可能性极低，但大量的实验证据表明，BM 来源的细胞能够通过尚未明确的再生过程促进β细胞的存活或内源性再生。这些新的实验体外和体内数据将在不久的将来扩大涉及 BM 或 BM 衍生细胞的临床试验，以治愈 1 型和 2 型人类糖尿病。在这篇综述中，我们回顾了 BM 在糖尿病治疗中的应用历史，并提供了关于 BM 和 BM 衍生干细胞参与胰岛细胞再生过程的临床相关实际信息。此外，还讨论了将 BM 用作胰岛的“饲养组织”以及 BM 在糖尿病治疗中的新临床用途等新方面。
