Pathak Varun, Pathak Nupur Madhur, O'Neill Christina L, Guduric-Fuchs Jasenka, Medina Reinhold J
Centre for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom.
The SAAD Centre for Pharmacy and Diabetes, School of Biomedical Sciences, University of Ulster, Coleraine, United Kingdom.
Clin Med Insights Endocrinol Diabetes. 2019 May 3;12:1179551419844521. doi: 10.1177/1179551419844521. eCollection 2019.
Type 1 diabetes (T1D) is caused by autoimmune destruction of insulin-producing β cells located in the endocrine pancreas in areas known as islets of Langerhans. The current standard-of-care for T1D is exogenous insulin replacement therapy. Recent developments in this field include the hybrid closed-loop system for regulated insulin delivery and long-acting insulins. Clinical studies on prediction and prevention of diabetes-associated complications have demonstrated the importance of early treatment and glucose control for reducing the risk of developing diabetic complications. Transplantation of primary islets offers an effective approach for treating patients with T1D. However, this strategy is hampered by challenges such as the limited availability of islets, extensive death of islet cells, and poor vascular engraftment of islets post-transplantation. Accordingly, there are considerable efforts currently underway for enhancing islet transplantation efficiency by harnessing the beneficial actions of stem cells. This review will provide an overview of currently available therapeutic options for T1D, and discuss the growing evidence that supports the use of stem cell approaches to enhance therapeutic outcomes.
1型糖尿病(T1D)是由位于内分泌胰腺中被称为胰岛的区域内产生胰岛素的β细胞发生自身免疫性破坏所致。目前T1D的标准治疗方法是外源性胰岛素替代疗法。该领域的最新进展包括用于调节胰岛素递送的混合闭环系统和长效胰岛素。关于糖尿病相关并发症预测和预防的临床研究表明,早期治疗和血糖控制对于降低发生糖尿病并发症的风险至关重要。原发性胰岛移植为治疗T1D患者提供了一种有效方法。然而,该策略受到诸如胰岛可用性有限、胰岛细胞大量死亡以及移植后胰岛血管植入不良等挑战的阻碍。因此,目前正在做出相当大的努力,通过利用干细胞的有益作用来提高胰岛移植效率。本综述将概述目前可用的T1D治疗选择,并讨论越来越多支持使用干细胞方法来提高治疗效果的证据。