干细胞治疗糖尿病的研究进展

随着糖尿病的发病率升高,世界各国科学家积极地寻找治疗糖尿病的有效方法.干细胞是近年来的研究热点之一,很多科学家着眼于应用干细胞治疗糖尿病,并取得了显著的成效.本文综合近些年来各国科学家的研究成果,从胚胎干细胞、胰腺干细胞、骨髓干细胞、骨髓造血干细胞等4个方面介绍当前的研究情况,同时时比4种干细胞治疗糖尿病的优缺点.     

脐带血造血干细胞治疗糖尿病的研究进展

脐带血造血干细胞具有极强的自我更新和多向分化潜能,为治疗糖尿病开辟了新的途径,造血干细胞在生成胰岛素分泌细胞前需要经过诱导分化、细胞选择和细胞成熟三个阶段。目前,脐带血造血干细胞在治疗糖尿病中已取得一定进展,将造血干细胞定向分化为胰岛β细胞成为了治疗的关键。本文通过对脐带血的特征、造血干细胞的制备和移植、糖尿病的治疗以及脐带血造血干细胞移植的利与弊等方面进行的归纳总结,分析脐带血造血干细胞在治疗糖尿病方面的进展和应用前景。     

人类干细胞制造的胰岛素获得突破

新华网报道 :以色列研究人员已成功地将人类胚胎干细胞转化为能制造胰岛素的细胞 ,在研究开发幼年型糖尿病治疗方法上取得了突破。干细胞由受精后数日的人类胚胎萃取。在培养皿中转为大量细胞 ,而这些细胞都具有分泌胰岛素的肾脏细胞的重要特征 ,这种细胞称为胰小岛细胞 ,或是贝他细胞。这项发现代表着在以胚胎干细胞治疗第一型糖尿病 ,也就是幼年型糖尿病方面迈出了重要一步。胚胎干细胞有能力转化为任何一种类型的细胞 ,科学家希望将这些干细胞移植到患者体内 ,产生健康的胰小岛细胞 ,分泌与控制胰岛素 ,用来治疗糖尿病。研究人员表示 ,这…     

干细胞与癌症

有“万能细胞”之称的干细胞可用于治疗多种疾病,如心肌梗死、中风、肝硬化、糖尿病、皮肤病、帕金森氏症以及癌症等几乎所有的常见病,其中干细胞治疗癌症(恶性肿瘤)更引人关注,预示着干细胞疗法将会决定今后医学发展的未来。目前,对干细胞的研究与应用取得了重要进展。     

我国干细胞治疗糖尿病的基础与临床研究

胰岛β细胞功能衰竭和胰岛素抵抗是导致糖尿病发生发展的主要机制,目前的抗糖尿病药物没有针对糖尿病发病的关键环节,只能解除或缓解症状,延缓疾病进展,不能从根本上治愈该疾病.干细胞通过促进胰岛β细胞原位再生,提高胰岛β细胞自噬能力、调节胰岛巨噬细胞功能修复受损的胰岛β细胞以改善胰岛β细胞功能;通过多种途径活化骨骼肌、脂肪和肝脏IRS(1)-AKT-GLUT4信号通路改善外周组织胰岛素抵抗,为糖尿病的精准治疗提供了新的方向.我国研究者针对不同来源的干细胞使用不同输注方式治疗1型糖尿病和2型糖尿病开展了系列研究,取得了良好的临床疗效,且未发生严重不良反应,为干细胞治疗糖尿病的临床应用奠定了基础.     

利用成体干细胞治疗糖尿病

糖尿病是一类严重的代谢疾病, 正危害着世界上越来越多人口的健康。胰岛移植是一种治疗糖尿病的有效方法,却因供体缺乏和移植后免疫排斥问题制约了其广泛应用。干细胞为具有强增殖能力和多向分化潜能的细胞, 是利用细胞替代疗法治疗重大疾病的细胞来源之一, 其中成体干细胞因不存在致瘤性及伦理道德问题而被人们寄予厚望。成体胰腺干细胞在活体损伤及离体培养条件下均能产生胰岛素分泌细胞, 肝干细胞、骨髓干细胞和肠干细胞等在特定离体培养条件下或经过遗传改造后也均可产生胰岛素分泌细胞, 将这些干细胞来源的胰岛素分泌细胞移植到模型糖尿病小鼠中可以治疗糖尿病。因而, 成体干细胞可以为细胞替代疗法治疗糖尿病提供丰富的胰岛供体来源。     

脂肪干细胞治疗勃起功能障碍新进展

勃起功能障碍(ED)常见于糖尿病患者和前列腺切除术后。治疗ED的传统方法常常难以见效,多年来,新方法仍未取得突破。令人兴奋的是干细胞移植治疗ED进入临床前阶段。最近的研究证明移植的干细胞可通过旁分泌作用于周围阴茎组织,并分化为平滑肌、内皮细胞和神经元。脂肪组织来源的干细胞因其丰富且易分离的特点成为有效可行的ED治疗手段。我们简要综述了脂肪干细胞用于ED治疗的新进展。     

胚胎干细胞向胰岛素分泌细胞定向分化的研究进展

I型糖尿病是胰岛β细胞破环的自身免疫性疾病.I型糖尿病胰岛移植是治疗I型糖尿病的有效方法.胚胎干细胞能够分化为包括胰岛素分泌细胞在内的多种细胞类型.胚胎干细胞是治疗I型糖尿病的潜在来源.综述了近年来胚胎干细胞分化为胰岛素分泌细胞的研究进展,主要阐述了胰腺发育的转录因子和不同的分化方法.     

从文献计量学角度评价干细胞技术治疗糖尿病发展历程

目的通过分析干细胞技术治疗糖尿病科技论文被国际权威检索工具PubMed收录情况,以评价干细胞技术治疗糖尿病的发展历程及应用前景。方法应用文献计量学和数理统计方法对PubMed收录干细胞技术治疗糖尿病领域科技论文进行统计分析。结果PubMed一共收录干细胞技术治疗糖尿病领域科技论文1413篇;美国、中国、日本3个地区发文量领先于其他地区;排名前三的发文机构为哈佛大学、加利福尼亚大学、东京大学和佛罗里达大学;国际期刊分布中Diabetes、Diabetologia、Stem Cells位列前三甲;高频被引文献集中在美国;主题分布中高频主题词有间充质干细胞、胚胎干细胞、造血干细胞、骨髓细胞等。结论干细胞技术治疗糖尿病起步于1971年,于2000年后快速发展,随着医学技术的发展和研究的深人,随着干细胞技术的日益成熟,彻底治疗糖尿病指日可待。     

糖尿病的细胞治疗

胰岛素产生细胞的缺陷或缺乏导致的Ⅰ型糖尿病是影响人类健康的重大疾病之一。最近细胞移植和组织工程的研究进展,使得糖尿病的细胞替代治疗成为可能,即通过胰岛素产生细胞的移植治疗Ⅰ型糖尿病和某些Ⅱ型糖尿病。但是由于供体细胞缺乏的限制,使得糖尿病的细胞治疗难以广泛开展。胰腺干细胞将成为胰岛素产生细胞的潜在来源。就Ⅰ型糖尿病的发病机制和治疗中存在的问题、胰腺干细胞的分离和分化、胰岛移植治疗糖尿病的局限性和干细胞治疗的必要性、糖尿病细胞治疗的探讨作如下介绍。     

Stem cell therapy for insulin-dependent diabetes: Are we still on the road?

In insulin-dependent diabetes, the islet β cells do not produce enough insulin and the patients must receive exogenous insulin to control blood sugar. However, there are still many deficiencies in exogenous insulin supplementation. Therefore, the replacement of destroyed functional β cells with insulin-secreting cells derived from functional stem cells is a good idea as a new therapeutic idea. This review introduces the development schedule of mouse and human embryonic islets. The differences between mouse and human pancreas embryo development were also listed. Accordingly to the different sources of stem cells, the important research achievements on the differentiation of insulin-secreting β cells of stem cells and the current research status of stem cell therapy for diabetes were reviewed. Stem cell replacement therapy is a promising treatment for diabetes, caused by defective insulin secretion, but there are still many problems to be solved, such as the biosafety and reliability of treatment, the emergence of tumors during treatment, untargeted differentiation and autoimmunity, etc. Therefore, further understanding of stem cell therapy for insulin is needed.     

Effect of metformin on stem cells: Molecular mechanism and clinical prospect

Metformin is a first-line medication for type II diabetes. Numerous studies have shown that metformin not only has hypoglycemic effects, but also modulates many physiological and pathological processes ranging from aging and cancer to fracture healing. During these different physiological activities and pathological changes, stem cells usually play a core role. Thus, many studies have investigated the effects of metformin on stem cells. Metformin affects cell differentiation and has promising applications in stem cell medicine. It exerts anti-aging effects and can be applied to gerontology and regenerative medicine. The potential anti-cancer stem cell effect of metformin indicates that it can be an adjuvant therapy for cancers. Furthermore, metformin has beneficial effects against many other diseases including cardiovascular and autoimmune diseases. In this review, we summarize the effects of metformin on stem cells and provide an overview of its molecular mechanisms and clinical prospects.     

Notch信号传导通路相关疾病的研究进展

Notch信号传导通路是影响细胞命运决定的重要通路之一,相邻细胞间通过Notch受体传递信号可以调节包括干细胞在内的多种细胞的分化、增殖和凋亡,影响器官形成和形态发生.Notch信号传导通路中某些分子的基因突变与多种疾病的发生发展有关.在深入研究Notch信号传导通路的基础上,以其作为靶点设计药物,对于治疗包括肿瘤、CADASIL等遗传性疾病在内的相关疾病,或发展干细胞医疗技术治疗阿尔茨海默症(Alzheimer!sdisease,AD)、帕金森病、糖尿病等细胞组织功能减退或受损性疾病具有重要的科学意义和应用价值.     

Generation of new islets from stem cells

Spain ranks number one in organ donors (35 per million per yr). Although the prevalence of diabetes is low (100,000 type 1 diabetic patients and 2 million type 2 diabetic patients), the expected number of patients receiving islet transplants should be estimated at 200 per year. Islet replacement represents a promising cure for diabetes and has been successfully applied in a limited number of type 1 diabetic patients, resulting in insulin independence for periods longer than 3 yr. However, it has been difficult to obtain sufficient numbers of islets from cadaveric donors. Interesting alternatives include acquiring renewable sources of cells using either embryonic or adult stem cells to overcome the islet scarcity problem. Stem cells are capable of extensive proliferation rates and are capable of differentiating into other cell types of the body. In particular, totipotent stem cells are capable of differentiating into all cell types in the body, whereas pluripotent stem cells are limited to the development of a certain number of differentiated cell types. Insulin-producing cells have been obtained from both embryonic and adult stem cells using several approaches. In animal models of diabetes, the therapeutic application of bioengineered insulin-secreting cells derived from stem cells has delivered promising results. This review will summarize the different approaches that have been used to obtain insulin-producing cells from embryonic and adult stem cells and highlights the key points that will allow in vitro differentiation and subsequent transplantation in the future.     

Research status and prospect of stem cells in the treatment of diabetes mellitus

Beta cell mass and function are decreased to varying degrees in diabetes. Islet cell replacement or regenerative therapy may offer great therapeutic promise to people with diabetes. In addition to primary pancreatic β cells, recent studies on regeneration of functional insulin producing cells (IPCs) revealed that several alternative cell sources, including embryonic stem cells, induced pluripotent stem cells and adult stem cells, can generate IPCs by differentiation, reprogramming, and trans-differentiation. In this review, we discuss stem cells as a potential alternative cell source for the treatment of diabetes.     

Generation of insulin-producing beta cells from stem cells--perspectives for cell therapy in type 1 diabetes

Cell based therapy for the treatment of type 1 diabetes is limited by the overall shortage of donor organs for transplantation. This is the rationale for the research on the generation of insulin-producing beta cells from an inexhaustible source of cells such as the stem cells. Stem cells are progenitor cells which possess the capacity of self-renewing and differentiation in fully mature cells depending on the culture conditions. The fundamental question is how to make terminally matured pancreatic beta cells. During the last years different approaches for the neogenesis of beta cells have been described using embryonic stem cells, adult stem cells residing in the pancreas, or other nonpancreatic cell types. Although fully functional islets have not yet been derived from any stem cells, the use of stem cells is still the most promising approach on the way to establish a treatment protocol for the cure of type 1 diabetes in the future.     

Gastrointestinal stem cells. I. Pancreatic stem cells

The transplantation of islets isolated from donor pancreas has renewed the interest in cell therapy for the treatment of diabetes. In addition, the capacity that stem cells have to differentiate into a wide variety of cell types makes their use ideal to generate beta-cells for transplantation therapies. Several studies have reported the generation of insulin-secreting cells from embryonic and adult stem cells that normalized blood glucose values when transplanted into diabetic animal models. Finally, although much work remains to be done, there is sufficient evidence to warrant continued efforts on stem cell research to cure diabetes.     

Amniotic fluid stem cells to study mTOR signaling in differentiation

The protein kinase mTOR is the central player within a pathway, which is known to be involved in the regulation of e.g., cell size, cell cycle, apoptosis, autophagy, aging and differentiation. mTOR activity responds to many signals, including cellular stress, oxygen, nutrient availability, energy status and growth factors. Deregulation of this enzyme is causatively involved in the molecular development of monogenic human diseases, cancer, obesity, type 2 diabetes or neurodegeneration. Recently, mTOR has also been demonstrated to control stem cell homeostasis. A more detailed investigation of this new mTOR function will be of highest relevance to provide more explicit insights into stem cell regulation in the near future. Different cellular tools, including adult stem cells, embryonic stem cells or induced pluripotent stem cells could be used to investigate the role of mTOR in mammalian stem cell biology. Here we discuss the potential of amniotic fluid stem cells to become a promising cellular model to study the role of signaling cascades in stem cell homeostasis.