Stem Cells for the Cell and Molecular Therapy of Type 1 Diabetes Mellitus (T1D) between Lights and Shadows
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 17, Issue 2
Abstract
The restricted availability of cadaveric human donor pancreases coupled with the invariable need for treating the grafted patients with life-long general pharmacologic immunosuppression sharply limits progress of pancreatic islet cell transplantation into widespread clinical trials for the cure of T1D. While new micro-/macro-devices are being used to avert graft immune rejection, with no host’s general immunosuppression, the chronic lack of human insulin-producing donor cells represents a formidable hurdle. Hence, access to possibly unlimited sources of insulin making cells could offer a solution. Human stem cells derived from either embryos, or adult tissues, could yield virtually unlimited cell source. While the former still poses ethical and technical problems, the latter encounters mainly technical obstacles. As for embryonic stem cells, upon differentiation of the original pluripotent stem cells towards endocrine cell lineages, they have been reported to correct hyperglycemia upon graft into immune-incompetent mice, while immune rejection issues are still pending.However, at this time, only sporadic papers are available, waiting for confirmatory data. The same virtually applies to pilot early safety, sub-therapeutic clinical trials, recently begun in patients with T1D. In terms of adult cellular elements, mesenchymal stem cells derived from either bone marrow, or adipose tissue, or placenta or the umbilical cord Wharton Jelly can be isolated with no particular difficulties. They couple an intrinsic ability to transition into the definitive entoderm, towards beta-like insulin secreting cells, with powerful immunoregulatory properties. Less data is available for adult cells induced into pluripotency, by genetic engineering, there after re-differentiated into insulin producing cells.
Authors and Affiliations
Riccardo Calafiore, Giuseppe Basta Basta, Massimiliano Cavallo, Francesco Gaggia
Keywords
Related Articles
- EP ID EP590738
- DOI 10.26717/BJSTR.2019.17.002961
- Views 177
- Downloads 0
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