Department of General and Transplant Surgery, Ruprecht-Karls-University, Heidelberg, Germany.
Clin Transplant. 2013 Jul-Aug;27 Suppl 25:30-3. doi: 10.1111/ctr.12153.
Cell transplantation is a treatment option for diabetes, metabolic liver disease in children, and leukemia. Except for the latter indication, solid organ transplantation is one of the available therapies but can be replaced by cell transplantation. However, due to the limited amount of cells that can be transplanted and due to rejection, results of cell transplants are still inferior to solid organ transplantation; there is a general shortage of donor organs, and cell isolation is limited to organs which cannot be transplanted as a whole for anatomic reasons. Therefore, alternatives to islets and beta cells are needed. There are some cells which can be generated from the recipient and would not be rejected; still, immunosuppression would be required to prevent reoccurrence of type I diabetes unless durable tolerance to beta cells could be induced. Generating beta cells for transplant from the recipient would help to overcome the lack of available organs. Moreover, understanding the underlying mechanisms of differentiation of these cells into beta-like cells would deepen our understanding of both pathophysiology and development of diabetes mellitus type I. This article examines embryonal stem cells, induced pluripotent cells, mesenchymal stromal cells, and hepatocytes as potential alternatives to beta-cell transplantation.
细胞移植是治疗糖尿病、儿童代谢性肝病和白血病的一种选择。除了后者的适应症外，实体器官移植是可用的治疗方法之一，但可以被细胞移植所替代。然而，由于可移植细胞的数量有限，以及排斥反应的存在，细胞移植的效果仍然不如实体器官移植；供体器官普遍短缺，细胞分离仅限于由于解剖原因不能作为整体移植的器官。因此，需要寻找胰岛和β细胞的替代品。有一些可以从受者中产生的细胞，并且不会被排斥；但是，仍然需要免疫抑制来预防 1 型糖尿病的复发，除非可以诱导对β细胞的持久耐受。从受者中生成用于移植的β细胞有助于克服可用器官缺乏的问题。此外，了解这些细胞分化为β样细胞的潜在机制将加深我们对 1 型糖尿病的病理生理学和发病机制的理解。本文研究了胚胎干细胞、诱导多能干细胞、间充质基质细胞和肝细胞作为β细胞移植的潜在替代品。
