Stem cell-based immunomodulation in type 1 diabetes: beyond the regenerative approach

Curr Pharm Des. 2011;17(29):3229-42. doi: 10.2174/138161211798157595.

Abstract

Type 1 diabetes (T1D) is an autoimmune disease, leading to pancreatic β-cell destruction and loss of glycaemic control. Administration of exogenous insulin to diabetic patients prevents life-threatening metabolic derangement, but may fail to prevent other longterm complications, such as kidney failure or diabetic retinopathy. Islet transplantation is a low-risk surgical procedure, affording improved glucose homeostasis provided sufficient islets engraft in the liver. Here we review work on the use of stem cells to generate β- cells for islet transplantation, indicating the need for improved protocols for their derivation and full maturation. We also consider recent evidence indicating that adult stem/progenitor cells may affect islet transplantation by improving the viability of engrafted islets and controlling immune reactions to islet allo- and auto-antigens, extending stem-cell use in T1D beyond the regenerative approach.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Autoantigens / immunology
  • Cell Survival
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / therapy*
  • Humans
  • Immunotherapy / methods
  • Insulin-Secreting Cells / transplantation
  • Islets of Langerhans Transplantation / methods*
  • Stem Cell Transplantation / methods*

Substances

  • Autoantigens