Type 1 diabetes is characterized by the selective destruction of pancreatic beta-cells caused by an autoimmune attack. Type 2 diabetes is a more complex disease which, in addition to beta-cell loss caused by apoptotic programs, includes beta-cell dedifferentiation and peripheral insulin resistance. In both type 1 and type 2 diabetes, insufficient numbers of insulin-producing beta cells are a major cause of defective control of blood glucose. Restoration of damaged beta-cells by transplantation from exogenous sources or by endocrine pancreas regeneration would be ideal therapeutic options. Reversal of diabetes can be achieved through islet transplantation and since the development of the Edmonton Islet Transplantation Protocol, islet transplantation has given new hope to patients with type 1 diabetes. However, due to the shortage of available donor tissue, finding an alternative source of islet tissue has become an increasingly important field of study. Efforts to achieve this goal explore several directions. The possibility of generating insulin-secreting cells and islet tissue with adult pancreatic stem or progenitor cells has been investigated extensively. Based on the realization that beta cells are capable of significant proliferation throughout adult life, the enhanced proliferation of beta cells in vivo or in vitro is pursued as a strategy for regenerative medicine for diabetes. Alternatively, the conversion of differentiated cells such as hepatocytes into beta cells is being attempted using molecular insights into the transcriptional makeup of beta cells. Advances were also made in directing the differentiation of embryonic stem cells into beta cells. Although progress is encouraging, major gaps in our understanding of developmental biology of the pancreas and adult beta-cell dynamics remain to be closed before a therapeutic application is made possible. This review aims to discuss recent progress in the study of adult pancreatic stem or progenitor cells and to suggest future directions in this field.
|Number of pages||19|
|Journal||Giornale Italiano di Diabetologia e Metabolismo|
|Publication status||Published - Jun 2008|
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Internal Medicine