JDRF, New York, NY 10004, USA.
Departments of Cellular and Physiological Sciences, and Surgery, Life Sciences Institute, School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Cell Metab. 2019 Mar 5;29(3):545-563. doi: 10.1016/j.cmet.2019.02.007.
Incredible strides have been made since the discovery of insulin almost 100 years ago. Insulin formulations have improved dramatically, glucose levels can be measured continuously, and recently first-generation biomechanical "artificial pancreas" systems have been approved by regulators around the globe. However, still only a small fraction of patients with diabetes achieve glycemic goals. Replacement of insulin-producing cells via transplantation shows significant promise, but is limited in application due to supply constraints (cadaver-based) and the need for chronic immunosuppression. Over the past decade, significant progress has been made to address these barriers to widespread implementation of a cell therapy. Can glucose levels in people with diabetes be normalized with artificial pancreas systems or via cell replacement approaches? Here we review the road ahead, including the challenges and opportunities of both approaches.
自近 100 年前发现胰岛素以来，已经取得了令人难以置信的进展。胰岛素制剂有了显著改善，葡萄糖水平可以连续测量，最近第一代生物机械“人工胰腺”系统已获得全球监管机构的批准。然而，糖尿病患者中仍只有一小部分达到了血糖目标。通过移植来替代产生胰岛素的细胞显示出了巨大的希望，但由于供应限制（基于尸体）和对慢性免疫抑制的需求，其应用受到限制。在过去的十年中，在克服细胞治疗广泛应用的这些障碍方面取得了重大进展。人工胰腺系统或通过细胞替代方法能否使糖尿病患者的血糖水平正常化？在这里，我们回顾了前进的道路，包括这两种方法的挑战和机遇。
