Cell therapy for type 2 diabetes: is it desirable and can we get it?
The functional mass of beta-cells is decreased in type 2 diabetes. Replacing missing beta-cells or triggering their regeneration may thus allow for improved treatment of type 2 diabetes, to the extent that this is combined with therapy for improved insulin sensitivity. Although progress has been made in deriving beta-cell-like cells from stem or precursor cells in vitro, these cannot yet be obtained in sufficient quantities or well enough differentiated to envisage their therapeutic use in beta-cell replacement therapy. Likewise, our very limited understanding of beta-cell regeneration in adult man does not yet allow for development of a valid strategy for kick-starting such a process in individuals with type 2 diabetes, whether by bona fide neogenesis or self-replication of existing beta-cells. Regardless of how beta-cell mass is restored in type 2 diabetes, it will be important to prevent any renewed decrease thereafter. Current understanding suggests that islet inflammation as well as signals from (insulin-resistant/inflamed) adipose tissue and skeletal muscle contribute towards decreased beta-cell mass in type 2 diabetes. It will likely be important to protect newly formed or implanted beta-cells from these negative influences to ensure their long-term survival.
Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland. philippe.halban@medecine.unige.ch
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D000818:Animals; D064987:Cell- and Tissue-Based Therapy / Q000379:methods* / Q000639:trends; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007515:Islets of Langerhans / Q000166:cytology* / Q000502:physiology; D008297:Male; D033581:Stem Cell Transplantation / Q000379:methods* / Q000639:trends