Regeneration therapy of pancreatic beta cells: towards a cure for diabetes?

Abstract

Regeneration therapy is an approach which could potentially move us towards a cure for type 1 diabetes. It is classified into three categories: (1) In vitro regeneration therapy using transplanted cultured cells, including ES cells, pancreatic stem cells, and beta-cell lines, in conjunction with immunosuppressive therapy or immunoisolation. (2) In ex vivo regeneration therapy, patients' own cells, such as bone marrow stem cells, are transiently removed and induced to differentiate into beta cells in vitro. At present, however, insulin-producing cells cannot be generated from bone marrow stem cells. (3) In in vivo regeneration therapy, impaired tissues regenerate from patients' own cells in vivo. beta-Cell neogenesis from non-beta-cells and beta-cell proliferation in vivo have been considered, particularly as regeneration therapies for type 2 diabetes. Regeneration therapy of pancreatic beta cells can be combined with various other therapeutic strategies, including islet transplantation, cell-based therapy, gene therapy, and drug therapy to promote beta-cell proliferation and neogenesis, and it is hoped that these strategies will, in the future, provide a cure for diabetes.