Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Neihu, Taipei 114, Taiwan.
Int J Endocrinol. 2012;2012:296485. doi: 10.1155/2012/296485. Epub 2012 May 29.
Islet transplantation is a promising therapy for patients with type 1 diabetes that can provide moment-to-moment metabolic control of glucose and allow them to achieve insulin independence. However, two major problems need to be overcome: (1) detrimental immune responses, including inflammation induced by the islet isolation/transplantation procedure, recurrence autoimmunity, and allorejection, can cause graft loss and (2) inadequate numbers of organ donors. Several gene therapy approaches and pharmaceutical treatments have been demonstrated to prolong the survival of pancreatic islet grafts in animal models; however, the clinical applications need to be investigated further. In addition, for an alternative source of pancreatic β-cell replacement therapy, the ex vivo generation of insulin-secreting cells from diverse origins of stem/progenitor cells has become an attractive option in regenerative medicine. This paper focuses on the genetic manipulation of islets during transplantation therapy and summarizes current strategies to obtain functional insulin-secreting cells from stem/progenitor cells.
胰岛移植是一种有前途的 1 型糖尿病治疗方法，它可以提供葡萄糖的即时代谢控制，使患者能够实现胰岛素独立性。然而，有两个主要问题需要克服：（1）有害的免疫反应，包括胰岛分离/移植过程引起的炎症、自身免疫复发和同种异体排斥反应，会导致移植物丢失；（2）供体器官数量不足。已经有几种基因治疗方法和药物治疗方法被证明可以延长动物模型中胰岛移植物的存活时间；然而，还需要进一步研究其临床应用。此外，作为替代的胰腺 β 细胞替代治疗的来源，从不同来源的干细胞/祖细胞体外生成胰岛素分泌细胞已成为再生医学中一个有吸引力的选择。本文重点介绍胰岛在移植治疗过程中的基因操作，并总结了从干细胞/祖细胞获得功能性胰岛素分泌细胞的当前策略。
