Toward cell-based therapy of type I diabetes.
Type 1 diabetes (T1D) is an autoimmune disease that results from the destruction of insulin-producing pancreatic islet cells owing to the aggressive effector function of autoreactive T cells. In addition to lifetime supply of exogenous insulin, whole-pancreas or islet transplantation is presently the only alternative therapy for severely ill patients. Here, we discuss the current status of the development of cell-based therapies that are based on essentially two options, i.e. replacement of islet cells by islet-like cells derived from embryonic or adult stem cells, and re-establishment of immunological tolerance to islet self-antigens through regulatory T cells and/or tolerance-promoting monocyte-derived cells. A combination of both approaches will be required to turn cell-based therapy of T1D into clinical success.
Kabelitz
Dieter
D
Institute of Immunology, University Hospital Schleswig-Holstein, Kiel, Germany. kabelitz@immunologie.uni-kiel.de
Geissler
Edward K
EK
Soria
Bernat
B
Schroeder
Insa S
IS
Fändrich
Fred
F
Chatenoud
Lucienne
L
D000818:Animals; D001324:Autoantigens / Q000276:immunology; D015551:Autoimmunity; D002454:Cell Differentiation; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000166:cytology / Q000378:metabolism*; D007515:Islets of Langerhans / Q000166:cytology / Q000276:immunology / Q000378:metabolism; D016381:Islets of Langerhans Transplantation; D009000:Monocytes / Q000276:immunology*; D017634:Self Tolerance; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000166:cytology* / Q000378:metabolism; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000378:metabolism
D001324:Autoantigens; D007328:Insulin