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糖尿病的治疗选择:干细胞的潜在作用。

Treatment options for diabetes: potential role of stem cells.

机构信息

Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, 1 Discovery Drive, Rensselaer, NY 12144, USA.

出版信息

Diabetes Res Clin Pract. 2012 Dec;98(3):361-8. doi: 10.1016/j.diabres.2012.09.010. Epub 2012 Sep 26.

Abstract

There are diseases and injuries in which a patient's cells or tissues are destroyed that can only be adequately corrected by tissue or organ transplants. Stem cells may be able to generate new tissue and even cure diseases for which there is no adequate therapy. Type 1 diabetes (T1DM), an insulin-dependent diabetes, is a chronic disease affecting genetically predisposed individuals, in which insulin-secreting beta (β)-cells within pancreatic islets of Langerhans are selectively and irreversibly destroyed by autoimmune assault. Type 2 diabetes (T2DM) is characterized by a gradual decrease in insulin sensitivity in peripheral tissues and the liver (insulin resistance), followed by a gradual decline in β-cell function and insulin secretion. Successful replacing of damaged β-cells has shown considerable potential in treating T1DM, but lack of adequate donors is a barrier. The literature suggests that embryonic and adult stem cells are promising alternatives in long-term treatment of diabetes. However, any successful strategy should address both the need for β-cell replacement and controlling the autoimmune response to cells that express insulin. This review summarizes the current knowledge of options and the potential of stem cell transplantation in diabetes treatment.

摘要

有些疾病和损伤会导致患者的细胞或组织被破坏,而只有通过组织或器官移植才能得到充分纠正。干细胞可能能够产生新的组织,甚至可以治愈那些没有有效治疗方法的疾病。1 型糖尿病(T1DM)是一种依赖胰岛素的糖尿病,是一种影响遗传易感性个体的慢性疾病,其中胰岛内的胰岛素分泌β(β)细胞被自身免疫攻击选择性地、不可逆转地破坏。2 型糖尿病(T2DM)的特征是外周组织和肝脏的胰岛素敏感性逐渐下降(胰岛素抵抗),随后β细胞功能和胰岛素分泌逐渐下降。成功替代受损的β细胞在治疗 T1DM 方面显示出了相当大的潜力,但缺乏足够的供体是一个障碍。文献表明,胚胎和成体干细胞是治疗糖尿病的长期替代方案。然而,任何成功的策略都应该同时解决β细胞替代的需求和控制对表达胰岛素的细胞的自身免疫反应。本综述总结了目前在糖尿病治疗中干细胞移植的选择和潜力。

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