Current Status of Islet Cell Replacement and Regeneration Therapy
Current Status of Islet Cell Replacement and Regeneration Therapy
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DOI：
10.1210/jc.2009-1819
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发表时间：
2010-03-01
影响因子：
5.8
通讯作者：
Weir, Gordon C.
中科院分区：
文献类型：
--
作者：
Halban, Philippe A.;German, Michael S.;Weir, Gordon C.
背景：1型和2型糖尿病患者的B细胞数量和功能均不同程度地降低。在未来，胰岛细胞替代或再生疗法可能因此提供治疗糖尿病患者的好处，但有重大挑战要克服evidence Acquisition：对已发表的同行评审的医学文献β细胞的发展和再生进行了审查。只有被认为最相关的出版物被选中引用，特别注意2000-2009年期间，并列入早期的里程碑式studies.Evidence合成：胰岛细胞再生治疗可以通过原位再生或植入以前在体外衍生的细胞来实现。这两种方法都在探索中，它们的最终成功将取决于重演内分泌胰腺正常发育中的关键事件以获得功能正常的完全分化的胰岛细胞的能力。关于单独的β细胞是否能确保足够的代谢控制，或者是否有必要用其各种细胞类型和独特的综合功能再生胰岛，也存在争议。任何方法都必须考虑到再生治疗的潜在危险。结论：胰岛细胞再生治疗有一天可能会改善糖尿病的治疗方法，并有可能治愈糖尿病。然而，各种方法都处于临床前开发的早期阶段，在证明安全性以及比现有疗法更有效之前，不应提供给患者。（临床内分泌代谢杂志95：1034-1043，2010）
Context: B cell mass and function are decreased to varying degrees in both type 1 and type 2 diabetes. In the future, islet cell replacement or regeneration therapy may thus offer therapeutic benefit to people with diabetes, but there are major challenges to be overcome.Evidence Acquisition: A review of published peer-reviewed medical literature on beta-cell development and regeneration was performed. Only publications considered most relevant were selected for citation, with particular attention to the period 2000-2009 and the inclusion of earlier landmark studies.Evidence Synthesis: Islet cell regenerative therapy could be achieved by in situ regeneration or implantation of cells previously derived in vitro. Both approaches are being explored, and their ultimate success will depend on the ability to recapitulate key events in the normal development of the endocrine pancreas to derive fully differentiated islet cells that are functionally normal. There is also debate as to whether beta-cells alone will assure adequate metabolic control or whether it will be necessary to regenerate islets with their various cell types and unique integrated function. Any approach must account for the potential dangers of regenerative therapy.Conclusions: Islet cell regenerative therapy may one day offer an improved treatment of diabetes and potentially a cure. However, the various approaches are at an early stage of preclinical development and should not be offered to patients until shown to be safe as well as more efficacious than existing therapy. (J Clin Endocrinol Metab 95: 1034-1043, 2010)