Minireview: β-Cell Replacement Therapy for Diabetes in the 21st Century: Manipulation of Cell Fate by Directed Differentiation

摘要

Pancreatic β-cell failure underlies type 1 diabetes; it also contributes in an essential way to type 2 diabetes. β-Cell replacement is an important component of any cure for diabetes. The current options of islet and pancreas transplantation are not satisfactory as definitive forms of therapy. Here, we review strategies for induced de novo pancreatic β-cell formation, which depend on the targeted differentiation of cells into pancreatic β-cells. With this objective in mind, one can manipulate the fate of three different types of cells: 1) from terminally differentiated cells, e.g. exocrine pancreatic cells, into β-cells; 2) from multipotent adult stem cells, e.g. hepatic oval cells, into pancreatic islets; and 3) from pluripotent stem cells, e.g. embryonic stem cells and induced pluripotent stem cells, into β-cells. We will examine the pros and cons of each strategy as well as the hurdles that must be overcome before these approaches to generate new β-cells will be ready for clinical application.