title: Stem cells for pancreatic β-cell replacement in diabetes mellitus: actual perspectives.
abstract: OBJECTIVE
  Type 1 and type 2 diabetes mellitus represent a widespread metabolic disorder, related to autoimmune β-cell destruction and insulin resistance, leading to β-cell dysfunction, respectively, that are associated with severe chronic complications with irreversible multiorgan morphological and functional damage. Conventional treatment, based on exogenous insulin or oral agents may control and delay but not prevent the disease complications, which has lead, so far, to a steady increase in mortality and morbidity. β-Cell substitution cell therapy, initially pursued by whole pancreatic and isolated islet transplantation, with scarce and limited efficiency, now is looking at the new technologies for cell and molecular therapy for diabetes, based on stem cells.
  
  
  RESULTS
  Pancreatic endocrine cells regeneration might replenish the destroyed β-cell pool, with neogenerated β-cell derived from pancreatic and extrapancreatic stem cell sources. Additionally, embryonic or adult stem cells derived from different cell lineages, and able to differentiate into β-like cell elements, may not only restore the original insulin secretory patterns but also exert the immunomodulatory effects aimed at interrupting the β-cell-directed autoimmune destruction vicious cycle.
  
  
  CONCLUSIONS
  These new strategies may, one day, provide for the final cure of diabetes mellitus.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Calafiore
authors.forename: Pia
authors.initials: P
authors.lastname: Montanucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Basta
mesh_terms: D000328:Adult; D053687:Adult Stem Cells / Q000637:transplantation*; D019070:Cell Lineage; D064987:Cell- and Tissue-Based Therapy; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D053595:Embryonic Stem Cells / Q000637:transplantation*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000637:transplantation*; D012038:Regeneration