Hematopoietic stem cell therapy for type 1 diabetes: induction of tolerance and islet cell neogenesis.
Diabetes is a chronic disease with significant morbidity and mortality. Pancreas or islet cell transplantation is limited by a shortage of donors and chronic immune suppression to prevent allograft rejection. Consequently, interest exists in islet cell neogenesis from embryonic or mesenchymal stem cell as a possible cure for diabetes. However, unless tolerance to islet cells is re-established, diabetes treated by islet cell transplantation would remain a chronic disease secondary to immune suppression related morbidity. If islet cell tolerance could be re-induced, a major clinical hurdle to curing diabetes by islet cell neogenesis may be overcome. Recent studies suggest that adult hematopoietic stem cells (HSC) can reintroduce tolerance to auto-antigens. It is possible that HSC may also be able to switch lineage and, therefore, be a convenient source of stem cells for both inducing tolerance and islet cell regeneration.
Burt
Richard K
RK
Department of Medicine, Northwestern University Medical Center, Chicago, IL 60611, USA. rburt@nmu.edu
Oyama
Yu
Y
Traynor
Ann
A
Kenyon
Norma S
NS
D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007515:Islets of Langerhans / Q000276:immunology; D019172:Transplantation Conditioning