Lilly Meredith A, Davis Meghan F, Fabie Josh E, Terhune Elizabeth B, Gallicano G Ian
Georgetown University School of Medicine, Georgetown University Medical Center Washington D.C., USA.
Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center Washington D.C., USA.
Am J Stem Cells. 2016 Oct 20;5(3):87-98. eCollection 2016.
Diabetes is a disease with wide-ranging personal and societal impacts that has been managed medicinally for over half a century. Since the discovery of stem cells, pancreatic islet regeneration has become a central target for clinical application that has the potential to decrease or eliminate the need for insulin administration and adjunctive medications. The discovery of alternative routes to pluripotency that bypass the ethical implications of embryonic stem cells has significantly expanded the horizons of stem cell based therapy. Engraftment of mature insulin producing cells derived from induced pluripotent stem cells may represent the most promising treatment strategy for diabetic patients with impaired β-cell function. These cells are easily accessible and have been shown to closely mimic endogenous β-cell function . While the risks of oncogenesis and transplant rejection are still of great concern, large strides have been made on both fronts with the application of integration free induction strategies and the ongoing development of microcapsules that cloak implanted cells from an autoimmune response. This review will focus on the progress and remaining obstacles in diabetes related stem cell research, and will specifically discuss approaches using embryonic, induced pluripotent, germline and mesenchymal derived stem cells.
糖尿病是一种对个人和社会有广泛影响的疾病,半个多世纪以来一直通过药物进行治疗。自干细胞被发现以来,胰岛再生已成为临床应用的核心目标,有望减少或消除胰岛素给药及辅助药物的需求。绕过胚胎干细胞伦理问题的多能性替代途径的发现,极大地拓展了基于干细胞治疗的视野。源自诱导多能干细胞的成熟胰岛素生成细胞的移植,可能是β细胞功能受损的糖尿病患者最有前景的治疗策略。这些细胞易于获取,且已显示出能紧密模拟内源性β细胞功能。虽然肿瘤发生和移植排斥的风险仍备受关注,但在无整合诱导策略的应用以及能使植入细胞免受自身免疫反应的微胶囊的不断研发方面,都已取得了长足进展。本综述将聚焦糖尿病相关干细胞研究的进展和尚存的障碍,并将具体讨论使用胚胎、诱导多能、生殖系和间充质来源干细胞的方法。