Recent Advances in Cell Replacement Therapies for the Treatment of Type 1 Diabetes

Abstract

Exogenous insulin administration is currently the only treatment available to all type 1 diabetes patients, but it is not a cure. By helping to regulate circulating blood glucose levels, it has significantly improved life expectancy, but there are still long-term complications associated with the disease that may be preventable with a treatment strategy that can provide better glycemic control. Isolated islet (or whole pancreas) transplantation, xenotransplantation, and the transplant of human pluripotent stem cell-derived β-cells provide the potential to restore endogenous insulin production and reestablish normoglycemia. Here, we discuss the latest advances in these fields, including the use of encapsulation technology, as well as some of the hurdles that still need to be overcome for these alternative therapies to become mainstream and/or progress to clinical development.

Adult cell plasticity in vivo: de-differentiation and transdifferentiation are back in style

“…In addition to β cells the pancreatic islets of Langerhans contain glucagon-producing α cells and somatostatin-producing δ cells 64 . In type I diabetes mellitus (T1DM), β cells are attacked by the immune system, leaving patients with an insufficient number of insulin-producing β cells 65 . The finding that T1DM can be successfully treated by transplanting patients with cadaver-derived islets has inspired many researchers to try to generate new β cells in vitro 66 .…”

Transforming growth factor-beta 1 delivery from microporous scaffolds decreases inflammation post-implant and enhances function of transplanted islets

“…Cell transplantation holds tremendous potential for regenerative strategies such as those focused on the heart [1], liver [2], nervous system [3], and diabetes [4]; however, cell survival following transplantation and long-term function pose significant hurdles for these therapies. To address these issues, biomaterial scaffolds designed to enhance cell survival, engraftment, and function at the implant site have been the focus of intense investigation [5–7].…”

Capsule stiffness regulates the efficiency of pancreatic differentiation of human embryonic stem cells

“…Recently, the Melton group and the Kieffer group have reported a significant breakthrough in generating glucose responsive insulin producing β cells from hPSCs in vitro [3,7]. While this will overcome the cell source restriction, the next step towards successful clinical translation of hPSC derived β cells for T1D therapy will require protection of the cells from the host immune system [8].…”