University of Miami Leonard M Miller School of Medicine, Diabetes Research Institute, Miami, FL, USA.
Expert Opin Biol Ther. 2012 Jun;12(6):731-41. doi: 10.1517/14712598.2012.679654. Epub 2012 Apr 16.
The study of the endocrine compartment of the pancreas (the islets of Langerhans) is of great translational interest, as strategies aimed at restoring its mass could become therapies for glycemic dysregulation in type 1 and 2 diabetes mellitus, drug-related diabetes following diabetogenic therapies or hyperglycemic disturbances following the treatment of cancer and nesidioblastosis. Such strategies generally fall under one of the 'three Rs,' namely, replacement (islet transplantation and stem cell differentiation), reprogramming (chiefly from the exocrine compartment of the pancreas) and regeneration (replication and induction of endogenous stem cells).
This expert opinion focuses on the latter, as islets are known to regenerate under specific circumstances of physiological (e.g., pregnancy), pathological (e.g., obesity, hyperglycemia, mutations in the glucose-sensing pathway) or experimental (e.g., partial pancreatectomy, cellophane wrapping, partial duct ligation) nature. This review presents the different models of pancreatic regeneration, which encompass the replication of existing beta-cells, reversible epithelial-to-mesenchymal transition and the reactivation of resident stem cells.
Rather than a set mechanism, the pancreas appears to possess a wide range of facultative regeneration pathways. These are discussed in the context of the development of potential strategies aimed at restoring beta-cell function in insulin-dependent diabetes.
研究胰腺内分泌部分（胰岛）具有重要的转化意义，因为旨在恢复其质量的策略可能成为 1 型和 2 型糖尿病、糖尿病相关治疗后药物引起的糖尿病或癌症治疗后高血糖紊乱和神经内分泌细胞瘤的治疗方法。这些策略通常属于“三个 R”之一，即替代（胰岛移植和干细胞分化）、重编程（主要来自胰腺外分泌部分）和再生（复制和诱导内源性干细胞）。
本专家意见重点介绍后者，因为已知在特定的生理情况下（例如怀孕）、病理情况下（例如肥胖、高血糖、葡萄糖感应途径突变）或实验情况下（例如部分胰腺切除术、玻璃纸包裹、部分胆管结扎）胰岛会发生再生。本文介绍了不同的胰腺再生模型，包括现有β细胞的复制、可逆上皮-间充质转化和常驻干细胞的再激活。
胰腺似乎具有广泛的兼性再生途径，而不是一种固定的机制。本文讨论了这些途径在恢复胰岛素依赖型糖尿病中β细胞功能的潜在策略发展中的意义。
