Inducible Pluripotent Stem Cells as a Potential Cure for Diabetes
Open Access
- 30 January 2021
- Vol. 10 (2), 278
- https://doi.org/10.3390/cells10020278
Abstract
Over the last century, diabetes has been treated with subcutaneous insulin, a discovery that enabled patients to forego death from hyperglycemia. Despite novel insulin formulations, patients with diabetes continue to suffer morbidity and mortality with unsustainable costs to the health care system. Continuous glucose monitoring, wearable insulin pumps, and closed-loop artificial pancreas systems represent an advance, but still fail to recreate physiologic euglycemia and are not universally available. Islet cell transplantation has evolved into a successful modality for treating a subset of patients with ‘brittle’ diabetes but is limited by organ donor supply and immunosuppression requirements. A novel approach involves generating autologous or immune-protected islet cells for transplant from inducible pluripotent stem cells to eliminate detrimental immune responses and organ supply limitations. In this review, we briefly discuss novel mechanisms for subcutaneous insulin delivery and define their shortfalls. We describe embryological development and physiology of islets to better understand their role in glycemic control and, finally, discuss cell-based therapies for diabetes and barriers to widespread use. In response to these barriers, we present the promise of stem cell therapy, and review the current gaps requiring solutions to enable widespread use of stem cells as a potential cure for diabetes.This publication has 180 references indexed in Scilit:
- Low Immunogenicity of Neural Progenitor Cells Differentiated from Induced Pluripotent Stem Cells Derived from Less Immunogenic Somatic CellsPLOS ONE, 2013
- TGF-β Signaling Regulates Pancreatic β-Cell Proliferation through Control of Cell Cycle Regulator p27 ExpressionACTA HISTOCHEMICA ET CYTOCHEMICA, 2013
- Potent Induction Immunotherapy Promotes Long-Term Insulin Independence After Islet Transplantation in Type 1 DiabetesAmerican Journal of Transplantation, 2012
- Inducible Apoptosis as a Safety Switch for Adoptive Cell TherapyThe New England Journal of Medicine, 2011
- Engineered polymer-media interfaces for the long-term self-renewal of human embryonic stem cellsBiomaterials, 2011
- Combinatorial treatment of bone marrow stem cells and stromal cell-derived factor 1 improves glycemia and insulin production in diabetic miceMolecular and Cellular Endocrinology, 2011
- Chemically defined conditions for human iPSC derivation and cultureNature Methods, 2011
- Consequences of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusionJournal of Diabetes and its Complications, 2010
- C-Peptide Levels and Insulin Independence Following Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes MellitusJAMA, 2009
- Insulin-induced remission in new-onset NOD mice is maintained by the PD-1–PD-L1 pathwayThe Journal of Experimental Medicine, 2006