title: New Insights into Diabetes Cell Therapy.
abstract: Since insulin discovery, islet transplantation was the first protocol to show the possibility to cure patients with type 1 diabetes using low-risk procedures. The scarcity of pancreas donors triggered a burst of studies focused on the production of new β cells in vitro. These were rapidly dominated by pluripotent stem cells (PSCs) demonstrating diabetes-reversal potential in diabetic mice. Subsequent enthusiasm fostered a clinical trial with immunoisolated embryonic-derived pancreatic progenitors. Yet safety is the Achilles' heel of PSCs, and a whole branch of β cell engineering medicine focuses on transdifferentiation of adult pancreatic cells. New data showed the possibility to chemically stimulate acinar or α cells to undergo β cell neogenesis and provide opportunities to intervene in situ without the need for a transplant, at least after weighing benefits against systemic adverse effects. The current studies suggested the pancreas as a reservoir of facultative progenitors (e.g., in the duct lining) could be exploited ex vivo for expansion and β cell differentiation in timely fashion and without the hurdles of PSC use. Diabetes cell therapy is thus a growing field not only with great potential but also with many pitfalls to overcome for becoming fully envisioned as a competitor to the current treatment standards.
authors.affiliation: Institut de Recherche Expérimentale et Clinique, Pediatric Research Laboratory, Université Catholique de Louvain, Brussels, Belgium. philippe.lysy@uclouvain.be.|Pediatric Endocrinology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium. philippe.lysy@uclouvain.be.
authors.forename: Philippe A
authors.initials: PA
authors.lastname: Lysy
authors.affiliation: Institut de Recherche Expérimentale et Clinique, Pediatric Research Laboratory, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Elisa
authors.initials: E
authors.lastname: Corritore
authors.affiliation: Institut de Recherche Expérimentale et Clinique, Pediatric Research Laboratory, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Etienne M
authors.initials: EM
authors.lastname: Sokal
mesh_terms: D000818:Animals; D054338:Cell Transdifferentiation; D064987:Cell- and Tissue-Based Therapy; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000166:cytology; D016381:Islets of Langerhans Transplantation / Q000379:methods; D010179:Pancreas / Q000378:metabolism
keywords: Diabetes; Islets of Langerhans; Pancreas; Progenitors; Transdifferentiation