Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy.
Curr Opin Organ Transplant. 2014 Apr;19(2):162-8. doi: 10.1097/MOT.0000000000000055.
Type 1 and type 2 diabetes mellitus represent a widespread metabolic disorder, related to autoimmune β-cell destruction and insulin resistance, leading to β-cell dysfunction, respectively, that are associated with severe chronic complications with irreversible multiorgan morphological and functional damage. Conventional treatment, based on exogenous insulin or oral agents may control and delay but not prevent the disease complications, which has lead, so far, to a steady increase in mortality and morbidity. β-Cell substitution cell therapy, initially pursued by whole pancreatic and isolated islet transplantation, with scarce and limited efficiency, now is looking at the new technologies for cell and molecular therapy for diabetes, based on stem cells.
Pancreatic endocrine cells regeneration might replenish the destroyed β-cell pool, with neogenerated β-cell derived from pancreatic and extrapancreatic stem cell sources. Additionally, embryonic or adult stem cells derived from different cell lineages, and able to differentiate into β-like cell elements, may not only restore the original insulin secretory patterns but also exert the immunomodulatory effects aimed at interrupting the β-cell-directed autoimmune destruction vicious cycle.
These new strategies may, one day, provide for the final cure of diabetes mellitus.
1 型和 2 型糖尿病是一种广泛存在的代谢紊乱，分别与自身免疫性β细胞破坏和胰岛素抵抗有关，导致β细胞功能障碍，与严重的慢性并发症相关，这些并发症会导致不可逆的多器官形态和功能损伤。基于外源性胰岛素或口服药物的传统治疗方法可以控制和延缓疾病的进展，但不能预防并发症的发生，这导致了迄今为止死亡率和发病率的稳步上升。β细胞替代细胞治疗最初通过全胰和分离胰岛移植来实现，但效果有限，现在人们正在关注基于干细胞的细胞和分子治疗糖尿病的新技术。
胰腺内分泌细胞的再生可能会补充被破坏的β细胞池，新生成的β细胞来源于胰腺和胰腺外的干细胞来源。此外，来自不同细胞谱系的胚胎或成体干细胞，并且能够分化为β样细胞成分，不仅可以恢复原始的胰岛素分泌模式，还可以发挥免疫调节作用，旨在中断针对β细胞的自身免疫破坏恶性循环。
这些新策略有朝一日可能为糖尿病的最终治愈提供帮助。
