1型糖尿病的干细胞治疗研究进展

Advancements of stem-cell therapy for type 1 diabetes mellitus

1型糖尿病是由于产生胰岛素的β细胞特征性的被破坏造成的自身免疫疾病。理想的治疗方法就是通过外源的或内源的移植使胰腺细胞再生。干细胞包括胚胎干细胞和成体干细胞,它们都有各自的特点。最近的数据显示这些干细胞能够在体外特定的培养条件下分化成为胰岛素产生细胞。虽然在很多的案例中,来源于干细胞的胰岛素产生细胞在实验中可以逆转糖尿病模型动物的高血糖,但是,要想达到明确的应用于临床,仍然存在几个问题:主要有与胰岛β细胞相似细胞系的获得、移植后的免疫相容性问题和肿瘤的形成。本文综述了从胚胎干细胞和成体干细胞获得胰岛素产生细胞的不同方法、分化后的细胞移植治疗情况以及干细胞治疗1型糖尿病存在的主要问题和可能解决的办法。

Type 1 diabetes is characterized by the selective destruction of pancreatic β-cells caused by an autoimmune attack. Restoration of damaged β-cells by transplantation from exogenous sources or by endocrine pancreas regeneration would be ideal therapeutic options. Stem cells of both embryonic and adult origin offer some interesting alternatives, taking into account the latest advances indicating that these cells could be the potential building blocks from which insulin secreting cells could be obtained in vitro under appropriate culture conditions. Although it has been reported that insulin-producing cells derived from stem cells have been shown to reverse experimentally induced diabetes in animal models, several concerns need to be solved before finding a definite medical application. These refer mainly to the obtainment of a cell population as similar as possible to pancreatic I^-cells, and to the problems related with the immune compatibility and tumor formation. This review will describe the different approaches that have been used to obtain insulin-producing cells from embryonic and adult stem cells, the effect of cell transplantation for treating type 1 diabetes mellitus and analyze the main problems of therapy with these stem cells and the possible solving methods.