Present Accomplishments and Future Prospects of Cell-Based Therapies for Type 1 Diabetes Mellitus
Citations Over TimeTop 10% of 2011 papers
Abstract
Diabetes -Pathogenesis, Genetics and Immunotherapy 296 sufficient -cell mass to achieve normoglycemia, along with restoration of immunologic tolerance, represents a highly attractive alternative. To this end, proposed mechanisms for islet regeneration consist of replication of pre-existing -cells, neogenesis from ductal and noncell progenitors, transdifferentiation of fully differentiated acinar cells and directeddifferentiation of stem cells (putative -cell progenitors/pancreatic stem cells; embryonic, mesenchymal, hematopoietic and umbilical cord blood-derived stem cells etc). While several studies demonstrate these mechanisms in mice, proving the occurrence of these phenomena in humans is hard to achieve. In this review, we will focus on various approaches to obtain an expandable mass of functional, insulin-secreting -cells, emphasizing the major cell candidates for -cell regeneration, the specific factors and stimuli involved in -cell differentiation and expansion and alternate strategies that may enhance the effective -cell mass and function. The basic science driving these discoveries and the obstacles that hinder clinical translation of these avenues will be highlighted from the perspective of islet transplantation.
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