Lo ultimo sobre terapia celular
Current Status of Islet Cell Replacement and
Regeneration Therapy
Philippe A. Halban, Michael S. German, Steven E. Kahn, and Gordon C. Weir
Department of Genetic Medicine and Development (P.A.H.), University of Geneva, 1211 Geneva 4,
Switzerland; Hormone Research Institute (M.S.G.), Diabetes Center, University of California, San
Francisco, San Francisco, California 94143-0534; Department of Medicine (S.E.K.), Division of
Metabolism, Endocrinology, and Nutrition, Veterans Affairs Puget Sound Health Care System and
University of Washington, Seattle, Washington 98195; and Section of Islet Transplantation and Cell
Biology (G.C.W.), Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02215
Context: cell mass and function are decreased to varying degrees in both type 1 and type 2
diabetes. In the future, islet cell replacement or regeneration therapy may thus offer therapeutic
benefit to people with diabetes, but there are major challenges to be overcome.
Evidence Acquisition: A review of published peer-reviewed medical literature on -cell development
and regeneration was performed. Only publications considered most relevant were selected for citation,
with particular attention to the period 2000–2009 and the inclusion of earlier landmark studies.
Evidence Synthesis: Islet cell regenerative therapy could be achieved by in situ regeneration or
implantation of cells previously derived in vitro. Both approaches are being explored, and their
ultimate success will depend on the ability to recapitulate key events in the normal development
of the endocrine pancreas to derive fully differentiated islet cells that are functionally normal.
There is also debate as to whether -cells alone will assure adequate metabolic control or whether
it will be necessary to regenerate islets with their various cell types and unique integrated function.
Any approach must account for the potential dangers of regenerative therapy.
Conclusions: Islet cell regenerative therapy may one day offer an improved treatment of diabetes
and potentially a cure. However, the various approaches are at an early stage of preclinical development
and should not be offered to patients until shown to be safe as well as more efficacious
than existing therapy. (J Clin Endocrinol Metab 95: 1034–1043, 2010)
Regeneration Therapy
Philippe A. Halban, Michael S. German, Steven E. Kahn, and Gordon C. Weir
Department of Genetic Medicine and Development (P.A.H.), University of Geneva, 1211 Geneva 4,
Switzerland; Hormone Research Institute (M.S.G.), Diabetes Center, University of California, San
Francisco, San Francisco, California 94143-0534; Department of Medicine (S.E.K.), Division of
Metabolism, Endocrinology, and Nutrition, Veterans Affairs Puget Sound Health Care System and
University of Washington, Seattle, Washington 98195; and Section of Islet Transplantation and Cell
Biology (G.C.W.), Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02215
Context: cell mass and function are decreased to varying degrees in both type 1 and type 2
diabetes. In the future, islet cell replacement or regeneration therapy may thus offer therapeutic
benefit to people with diabetes, but there are major challenges to be overcome.
Evidence Acquisition: A review of published peer-reviewed medical literature on -cell development
and regeneration was performed. Only publications considered most relevant were selected for citation,
with particular attention to the period 2000–2009 and the inclusion of earlier landmark studies.
Evidence Synthesis: Islet cell regenerative therapy could be achieved by in situ regeneration or
implantation of cells previously derived in vitro. Both approaches are being explored, and their
ultimate success will depend on the ability to recapitulate key events in the normal development
of the endocrine pancreas to derive fully differentiated islet cells that are functionally normal.
There is also debate as to whether -cells alone will assure adequate metabolic control or whether
it will be necessary to regenerate islets with their various cell types and unique integrated function.
Any approach must account for the potential dangers of regenerative therapy.
Conclusions: Islet cell regenerative therapy may one day offer an improved treatment of diabetes
and potentially a cure. However, the various approaches are at an early stage of preclinical development
and should not be offered to patients until shown to be safe as well as more efficacious
than existing therapy. (J Clin Endocrinol Metab 95: 1034–1043, 2010)
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