Georgetown University School of Medicine, Georgetown University Medical Center, Washington, DC 20057, USA.
Diabet Med. 2012 Jan;29(1):14-23. doi: 10.1111/j.1464-5491.2011.03433.x.
Type 1 diabetes mellitus--characterized by the permanent destruction of insulin-secreting β-cells--is responsive to cell-based treatments that replace lost β-cell populations. The current gold standard of pancreas transplantation provides only temporary independence from exogenous insulin and is fraught with complications, including increased mortality. Stem cells offer a number of theoretical advantages over current therapies. Our review will focus on the development of treatments involving tissue stem cells from bone marrow, liver and pancreatic cells, as well as the potential use of embryonic and induced pluripotent stem cells for Type 1 diabetes therapy. While the body of research involving stem cells is at once promising and inconsistent, bone marrow-derived mesenchymal stem cell transplantation seems to offer the most compelling evidence of efficacy. These cells have been demonstrated to increase endogenous insulin production, while partially mitigating the autoimmune destruction of newly formed β-cells. However, recently successful experiments involving induced pluripotent stem cells could quickly move them into the foreground of therapeutic research. We address the limitations encountered by present research and look toward the future of stem cell treatments for Type 1 diabetes.
1 型糖尿病——其特征为胰岛素分泌β细胞的永久性破坏——对基于细胞的治疗有反应，这些治疗可替代丢失的β细胞群体。目前胰腺移植的金标准仅提供对外源胰岛素的暂时独立性，并且存在许多并发症，包括死亡率增加。干细胞相对于当前疗法具有许多理论优势。我们的综述将重点介绍涉及骨髓、肝和胰腺细胞组织干细胞的治疗方法的发展，以及胚胎和诱导多能干细胞在 1 型糖尿病治疗中的潜在用途。虽然涉及干细胞的研究既有希望又不一致，但骨髓间充质干细胞移植似乎提供了最有说服力的疗效证据。这些细胞已被证明可以增加内源性胰岛素的产生，同时部分减轻新形成的β细胞的自身免疫破坏。然而，最近涉及诱导多能干细胞的成功实验可能会迅速将它们推向治疗研究的前沿。我们讨论了当前研究中遇到的局限性，并展望了 1 型糖尿病干细胞治疗的未来。
