Department of Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
Ageing Res Rev. 2013 Mar;12(2):469-78. doi: 10.1016/j.arr.2013.01.001. Epub 2013 Jan 11.
Type 1 and 2 diabetes are characterized by a deficiency in β-cell mass, which cannot be reversed with existing therapeutic strategies. Therefore, restoration of the endogenous insulin-producing cell mass holds great promise for curing diabetes in the future. Since the initial induction of insulin-producing cells (IPCs) from embryonic stem (ES) cells in 1999, several strategies and alternative cell sources have been developed to generate β-like cells, including direct differentiation from ES cells or induced pluripotent stem (iPS) cells, proliferation of existing adult β-cells, and reprogramming of non-pancreatic adult stem/mature cells or pancreatic non-β-cells to β-like-cells. However, several barriers persist in the translation of the aforementioned strategies into clinically applicable methods for IPC induction. We briefly review the most relevant studies for each strategy, and discuss the comparative merits and drawbacks. We propose that ex vivo patient-specific IPCs generated from iPS cells may be practical for cell transplantation in the near future, and in situ regeneration of IPCs from cells within the pancreas may be preferable for diabetes therapy.
1 型和 2 型糖尿病的特征是β细胞数量不足，这一缺陷无法通过现有的治疗策略逆转。因此，恢复内源性胰岛素产生细胞的数量有望在未来治愈糖尿病。自 1999 年首次从胚胎干细胞（ES 细胞）诱导产生胰岛素产生细胞（IPCs）以来，已经开发了几种策略和替代细胞来源来生成β样细胞，包括直接从 ES 细胞或诱导多能干细胞（iPS 细胞）分化、增殖现有的成年β细胞，以及将非胰腺成体干细胞/成熟细胞或胰腺非β细胞重编程为β样细胞。然而，将上述策略转化为可临床应用的 IPC 诱导方法仍然存在一些障碍。我们简要回顾了每种策略中最相关的研究，并讨论了它们的优缺点。我们提出，从 iPS 细胞体外生成的患者特异性 IPC 可能在不久的将来适用于细胞移植，而从胰腺内细胞原位再生 IPC 可能更适合糖尿病治疗。
