Regenerative medicine for insulin deficiency: creation of pancreatic islets and bioartificial pancreas.
Recent advances in pancreas organogenesis have greatly improved the understanding of cell lineage from inner cell mass to fully differentiated β-cells. Based upon such knowledge, insulin-producing cells similar to β-cells to a certain extent have been generated from various cell sources including embryonic stem cells (ESCs) and induced pluripotent stem (iPS) cells, although fully differentiated cells comparable to β-cells are not yet available. The bioartificial pancreas is a therapeutic approach to enable allo- and xenotransplantation of islets without immune suppression. Among several types of bioartificial pancreases (BAPs), micro-encapsulated porcine islets are already in use in clinical trials and may, perhaps, replace islet transplantation in the near future. Some types of bioartificial pancreas such as macro-encapsulation are also useful for keeping transplanted cells enclosed in case retrieval is necessary. Therefore, early clinical applications of artificially generated β-like cells, especially those from ESCs or iPS cells, will be considered in combination with retrievable BAPs.
Sumi
Shoichiro
S
Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan. sumi@frontier.kyoto-u.ac.jp
D000818:Animals; D015415:Biomarkers; D002454:Cell Differentiation; D019070:Cell Lineage; D002478:Cells, Cultured / Q000166:cytology / Q000187:drug effects / Q000637:transplantation; D003920:Diabetes Mellitus / Q000601:surgery*; D003921:Diabetes Mellitus, Experimental / Q000601:surgery; D018507:Gene Expression Regulation, Developmental; D006801:Humans; D050417:Insulin-Secreting Cells / Q000166:cytology; D007515:Islets of Langerhans / Q000166:cytology* / Q000502:physiology; D016381:Islets of Langerhans Transplantation; D038081:Organogenesis / Q000502:physiology*; D010179:Pancreas / Q000166:cytology / Q000196:embryology; D019397:Pancreas, Artificial; D012038:Regeneration; D033581:Stem Cell Transplantation; D013552:Swine; D014157:Transcription Factors / Q000502:physiology
D015415:Biomarkers; D014157:Transcription Factors