Naomi Berrie Diabetes Center & Department of Pediatrics, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032, USA.
Salesi Hospital, 60123 Ancona, Italy.
Stem Cell Reports. 2018 Dec 11;11(6):1407-1415. doi: 10.1016/j.stemcr.2018.11.006. Epub 2018 Nov 29.
Permanent neonatal diabetes mellitus (PNDM) can be caused by insulin mutations. We generated induced pluripotent stem cells from fibroblasts of a patient with PNDM and undetectable insulin at birth due to a homozygous mutation in the translation start site of the insulin gene. Differentiation of mutant cells resulted in insulin-negative endocrine stem cells expressing MAFA, NKX6.1, and chromogranin A. Correction of the mutation in stem cells and differentiation to pancreatic endocrine cells restored insulin production and insulin secretion to levels comparable to those of wild-type cells. Grafting of corrected cells into mice, followed by ablating mouse β cells using streptozotocin, resulted in normal glucose homeostasis, including at night, and the stem cell-derived grafts adapted insulin secretion to metabolic changes. Our study provides proof of principle for the generation of genetically corrected cells autologous to a patient with non-autoimmune insulin-dependent diabetes. These cases should be readily amenable to autologous cell therapy.
永久性新生儿糖尿病(PNDM)可由胰岛素基因突变引起。我们从一位 PNDM 患者的成纤维细胞中生成诱导多能干细胞,该患者出生时由于胰岛素基因翻译起始位点的纯合突变而导致胰岛素检测不到。突变细胞的分化导致胰岛素阴性内分泌干细胞表达 MAFA、NKX6.1 和嗜铬粒蛋白 A。在干细胞中纠正突变并分化为胰腺内分泌细胞可恢复胰岛素的产生和分泌,使其达到与野生型细胞相当的水平。将纠正后的细胞移植到小鼠体内,然后用链脲佐菌素消除小鼠β细胞,导致正常的葡萄糖稳态,包括在夜间,并且干细胞衍生的移植物适应了胰岛素分泌的代谢变化。我们的研究为生成与非自身免疫性胰岛素依赖型糖尿病患者同源的基因矫正细胞提供了原理证明。这些病例应该很容易接受自体细胞治疗。
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