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2015 ; 90
(4
): 546-54
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Regenerative medicine in diabetes
#MMPMID25841258
Matveyenko A
; Vella A
Mayo Clin Proc
2015[Apr]; 90
(4
): 546-54
PMID25841258
show ga
Diabetes is a common multisystem disease that results in hyperglycemia due to a
relative or absolute insulin deficiency. Improved glycemic control decreases the
risk of development and progression of microvascular and, to a lesser extent,
macrovascular complications and prevents symptomatic hyperglycemia. However,
complex treatment regimens aimed at improving glycemic control are associated
with an increased incidence of hypoglycemia. On paper at least, cellular
therapies arising from reprogramed stem cells or other somatic cell types would
provide ideal therapy for diabetes and the prevention of its complications. This
hypothesis has led to intensive efforts to grow ? cells from various sources. In
this review, we provide an overview of ?-cell development as well as the efforts
reported to date in terms of cellular therapy for diabetes. Engineering ?-cell
replacement therapy requires an understanding of how ? cells respond to other
metabolites such as amino acids, free fatty acids, and ketones. Indeed, efforts
thus far have been characterized by an inability of cellular replacement products
to adequately respond to metabolites that normally couple the metabolic state to
?-cell function and insulin secretion. Efforts to date intended to capitalize on
current knowledge of islet cell development and stimulus-secretion coupling of
the ? cell are encouraging but as yet of little clinical relevance.