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.     

诱导脐带间充质干细胞分化为胰岛素分泌细胞的方法探讨

β细胞功能受损会引发1型糖尿病和部分2型糖尿病,因此,向患者体内移植正常的β细胞是一种理想的治疗方法,但供体的严重紧缺限制了它的应用,研究者们试图用胰岛素分泌细胞(insulin producing cells,IPCs)来替代β细胞用于细胞移植治疗。脐带间充质干细胞(umbilical cord mesenchymal stem cells,UCMSCs)是一种多能干细胞,能够被诱导分化为IPCs,进而可以用于细胞移植治疗。该文综述了诱导UCMSCs分化为IPCs的主要方法(多步诱导法、基因工程法和共培养法),探讨了各方法存在的问题及改进方向,以期为这些方法的进一步完善提供有益信息。     

干细胞诱导分化为胰岛素分泌细胞的研究现状

胰腺或胰岛细胞移植是目前治疗Ⅰ型糖尿病和部分Ⅱ型糖尿病效果最理想的方法,但因来源组织短缺及需要终生服用免疫抑制剂等问题限制了它的广泛应用.利用胰腺或胰腺外的多能干细胞产生胰岛样细胞有望克服上述问题而用于治疗糖尿病.本文就将干细胞诱导分化为胰岛样细胞中所用的重要的转录因子和可溶性诱导因子及其作用以及胰岛素分泌细胞的来源做一综述.     

人诱导多能干细胞来源功能性胰岛β细胞的体外定向分化方法的建立

1型糖尿病是由胰岛β细胞功能受损、胰岛素分泌不足所致,目前,主要通过外源性胰岛素补充来治疗,但外源性胰岛素无法精准调控血糖,严重低血糖可危及生命。胰岛移植是一种替代疗法,但面临器官供体不足和异种来源胰岛β细胞存在人畜共患病交叉感染风险的问题。因此,获得足量且安全的胰岛β细胞是1型糖尿病细胞治疗面临的难题。本研究旨在通过人诱导多能干细胞(human induced pluripotent stem cells, hiPSCs)在体外向胰岛β细胞分化,提供一种潜在的1型糖尿病治疗新策略。为实现这一目标,我们采用了结合2D和3D培养系统的分化策略,模拟胰岛β细胞的体内发育环境,并使用多种生长因子调节在胰腺发育和β细胞分化中发挥重要作用的关键信号包括Notch信号通路(Notch signaling pathway)、Wnt信号通路(Wnt signaling pathway)、TGF-β/Smad信号通路(TGF-β/Smad signaling pathway)等,在体外将hiPSC定向诱导分化至胰岛β细胞。结果显示,在2D、3D结合的培养条件下,分化过程中定型内胚层细胞,胰腺祖细胞,胰腺...     

1型糖尿病的干细胞治疗研究进展

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.     

间充质干细胞诱导分化为胰岛分泌细胞治疗1型糖尿病

糖尿病是严重危害人类健康的一类疾病,注射胰岛素和胰岛移植虽能用于治疗糖尿病,但都存在一定的局限性。大量研究表明,间充质干细胞（mesenchymal stem cell,MSC）可以在化学以及生物因子的作用下,或通过基因转染的方式在体外被诱导分化为胰岛素分泌细胞,且移植后对糖尿病鼠模型有一定降血糖效果,因而成为糖尿病治疗领域的研究热点。文章综述了不同来源的MSC诱导分化为胰岛分泌细胞（insulin—producing cells,IPC）的方法及诱导分化后用于治疗1型糖尿病的研究进展。     

转录因子对干细胞高效定向分化为β细胞的作用

移植干细胞分化的胰岛β细胞能逆转糖尿病鼠的高血糖症,为细胞疗法临床应用于糖尿病治疗提供依据。但如何诱导干细胞高效、定向分化为具有分泌功能的胰岛β细胞,仍是当今世界难题。就影响干细胞分化为胰岛β细胞的关键转录因子PDX-1、Ngn3、NeuroD1、MafA的作用及机制进行综述,为干细胞高效定向分化提供新的思路。     

大鼠骨骼肌卫星细胞诱导分化为胰岛素生成细胞的研究

目的探讨大鼠骨骼肌卫星细胞（MDSCs）定向诱导分化为胰岛素生成细胞（IPCs）,为1型糖尿病的干细胞治疗提供一种新的研究思路。 方法通过二次酶消化法和差速贴壁培养法分离、培养大鼠MDSCs,利用不同的诱导培养液使MDSCs定向分化为IPCs,并对诱导后细胞进行形态观察,通过双硫腙染色和免疫组化染色对MDSCs-IPCs形态进行鉴定,采用Q-PCR和Western Blot方法检测MDSCs-IPCs中C-peptide和Insulin的表达,通过胰岛素释放实验检测MDSCs-IPCs的生物学功能,β细胞和MDSCs-IPCs两组间比较采用t检验。 结果MDSCs在接种4 h后开始贴壁部分细胞伸出小的突起,48 h后绝大多数细胞贴壁呈梭形、胞浆丰富、折光度高。随着培养时间的延长,细胞的梭形形状更为明显且生长迅速。免疫组化结果显示细胞表达Desmin、α-Sarcomeric Actinin、MyoD1、Myf5和PAX7。成胰诱导后MDSCs形成胰岛样的圆形细胞团,双硫腙染色呈猩红色,Insulin免疫组化染色阳性。Q-PCR结果显示MDSCs-IPCs中C-peptide和Insulin mRNA表达量分别是β细胞的0.73倍（P > 0.05）和0.79倍（P > 0.05）。胰岛素释放实验显示,5.6 mmol/L和16.7 nmlol/L葡萄糖刺激培养2 h后,β细胞和MDSCs-IPCs分泌胰岛素量分别为[（20.3±4.2）mU/L]、[（16.1±3.7）mU/L]、[（60.5±9.3）mU/L]和[（40.9±7.3）mU/L],葡萄糖可调节MDSCs-IPCs胰岛素的分泌。 结论MDSCs易于分离培养、增殖能力强,体外可诱导分化为有功能的IPCs,适合作为再生医学的种子细胞。     

小分子化合物在诱导干细胞分化为胰岛素分泌细胞中的研究进展

干细胞具有多向分化潜能,可以被小分子化合物诱导分化为胰岛素分泌细胞,进而移植到体内代替受损的胰岛β细胞,从根本上治愈糖尿病。小分子化合物种类繁多,具有无免疫原性、可控性强等优点,因此,利用小分子化合物诱导干细胞分化为胰岛素分泌细胞来治疗糖尿病是将来比较有前景的治疗方案。该综述主要分类概述了化学诱导法中经常使用的小分子化合物及其在相应阶段发挥的作用。     

胰高血糖素样肽-1与Ⅰ型糖尿病治疗

近年来研究表明,胰高血糖素样肽-1（GLP-1）对胰岛β细胞的分化、增殖均起重要作用,包括抑制β细胞凋亡、刺激β细胞增生、诱导干细胞分化为胰腺内分泌细胞,从而使被破坏的胰岛细胞恢复分泌胰岛素的功能,这些作用为其治疗Ⅰ型糖尿病提供了证据,使其成为Ⅰ型糖尿病治疗领域研究的热点。     

Human iPS Cell-Derived Insulin Producing Cells Form Vascularized Organoids under the Kidney Capsules of Diabetic Mice

Type 1 diabetes (T1D) is caused by autoimmune disease that leads to the destruction of pancreatic β-cells. Transplantation of cadaveric pancreatic organs or pancreatic islets can restore normal physiology. However, there is a chronic shortage of cadaveric organs, limiting the treatment of the majority of patients on the pancreas transplantation waiting list. Here, we hypothesized that human iPS cells can be directly differentiated into insulin producing cells (IPCs) capable of secreting insulin. Using a series of pancreatic growth factors, we successfully generated iPS cells derived IPCs. Furthermore, to investigate the capability of these cells to secrete insulin in vivo, the differentiated cells were transplanted under the kidney capsules of diabetic immunodeficient mice. Serum glucose levels gradually declined to either normal or near normal levels over 150 days, suggesting that the IPCs were secreting insulin. In addition, using MRI, a 3D organoid appeared as a white patch on the transplanted kidneys but not on the control kidneys. These organoids showed neo-vascularization and stained positive for insulin and glucagon. All together, these data show that a pancreatic organ can be created in vivo providing evidence that iPS cells might be a novel option for the treatment of T1D.     

Generation of insulin-producing cells from gnotobiotic porcine skin-derived stem cells

A major problem in the treatment of type 1 diabetes mellitus is the limited availability of alternative sources of insulin-producing cells for islet transplantation. In this study, we investigated the effect of bone morphogenetic protein 4 (BMP-4) treatments of gnotobiotic porcine skin-derived stem cells (gSDSCs) on their reprogramming and subsequent differentiation into insulin-producing cells (IPCs). We isolated SDSCs from the ear skin of a gnotobiotic pig. During the proliferation period, the cells expressed stem-cell markers Oct-4, Sox-2, and CD90; nestin expression also increased significantly. The cells could differentiate into IPCs after treatments with activin-A, glucagon-like peptide-1 (GLP-1), and nicotinamide. After 15 days in the differentiation medium, controlled gSDSCs began expressing endocrine progenitor genes and proteins (Ngn3, Neuro-D, PDX-1, NKX2.2, NKX6.1, and insulin). The IPCs showed increased insulin synthesis after glucose stimulation. The results indicate that stem cells derived from the skin of gnotobiotic pigs can differentiate into IPCs under the appropriate conditions in vitro. Our three-stage induction protocol could be applied without genetic modification to source IPCs from stem cells in the skin of patients with diabetes for autologous transplantation.     

Induction of insulin‐producing cells from umbilical cord blood‐derived stromal cells by activation of the c‐Met/HGF axis

Efficient and effective therapies are required for diabetes mellitus. The use of adult stem cells for treating diabetes represents a major focus of current research. We have attempted to differentiate adult stem cells produced from umbilical cord blood‐derived stromal cells into insulin‐producing cells (IPCs). By activating the c‐Met/HGF axis through temporal hypoxia treatment and hepatocyte growth factor (HGF) supplementation, our protocol resulted in the differentiation of cells into functional pancreatic endocrine cells with increased viability. Glucose stimulation test results showed that significantly greater amounts of C‐peptide and insulin were released from the differentiated cells than from undifferentiated cells. These IPCs were capable of reversing the hyperglycemia of diabetic mice. In conclusion, targeting the c‐Met/HGF axis can be considered an effective and efficient means of obtaining IPCs from adult stem cells.     

Pancreatic Insulin-Producing Cells Differentiated from Human Embryonic Stem Cells Correct Hyperglycemia in SCID/NOD Mice,an Animal Model of Diabetes

Background

Human pancreatic islet transplantation is a prospective curative treatment for diabetes. However, the lack of donor pancreases greatly limits this approach. One approach to overcome the limited supply of donor pancreases is to generate functional islets from human embryonic stem cells (hESCs), a cell line with unlimited proliferative capacity, through rapid directed differentiation. This study investigated whether pancreatic insulin-producing cells (IPCs) differentiated from hESCs could correct hyperglycemia in severe combined immunodeficient (SCID)/non-obese diabetic (NOD) mice, an animal model of diabetes.

Methods

We generated pancreatic IPCs from two hESC lines, YT1 and YT2, using an optimized four-stage differentiation protocol in a chemically defined culture system. Then, about 5–7×10⁶ differentiated cells were transplanted into the epididymal fat pad of SCID/NOD mice (n = 20). The control group were transplanted with undifferentiated hESCs (n = 6). Graft survival and function were assessed using immunohistochemistry, and measuring serum human C-peptide and blood glucose levels.

Results

The pancreatic IPCs were generated by the four-stage differentiation protocol using hESCs. About 17.1% of differentiated cells expressed insulin, as determined by flow cytometry. These cells secreted insulin/C-peptide following glucose stimulation, similarly to adult human islets. Most of these IPCs co-expressed mature β cell-specific markers, including human C-peptide, GLUT2, PDX1, insulin, and glucagon. After implantation into the epididymal fat pad of SCID/NOD mice, the hESC-derived pancreatic IPCs corrected hyperglycemia for ≥8 weeks. None of the animals transplanted with pancreatic IPCs developed tumors during the time. The mean survival of recipients was increased by implanted IPCs as compared to implanted undifferentiated hESCs (P<0.0001).

Conclusions

The results of this study confirmed that human terminally differentiated pancreatic IPCs derived from hESCs can correct hyperglycemia in SCID/NOD mice for ≥8 weeks.     

Improved differentiation of umbilical cord blood-derived mesenchymal stem cells into insulin-producing cells by PDX-1 mRNA transfection

Numerous studies have sought to identify diabetes mellitus treatment strategies with fewer side effects. Mesenchymal stem cell (MSC) therapy was previously considered as a promising therapy; however, it requires the cells to be trans-differentiated into cells of the pancreatic-endocrine lineage before transplantation. Previous studies have shown that PDX-1 expression can facilitate MSC differentiation into insulin-producing cells (IPCs), but the methods employed to date use viral or DNA-based tools to express PDX-1, with the associated risks of insertional mutation and immunogenicity. Thus, this study aimed to establish a new method to induce PDX-1 expression in MSCs by mRNA transfection. MSCs were isolated from human umbilical cord blood and expanded in vitro, with stemness confirmed by surface markers and multipotentiality. MSCs were transfected with PDX-1 mRNA by nucleofection and chemically induced to differentiate into IPCs (combinatorial group). This IPC differentiation was then compared with that of untransfected chemically induced cells (inducer group) and uninduced cells (control group). We found that PDX-1 mRNA transfection significantly improved the differentiation of MSCs into IPCs, with 8.3±2.5% IPCs in the combinatorial group, 3.21±2.11% in the inducer group and 0% in the control. Cells in the combinatorial group also strongly expressed several genes related to beta cells (Pdx-1, Ngn3, Nkx6.1 and insulin) and could produce C-peptide in the cytoplasm and insulin in the supernatant, which was dependent on the extracellular glucose concentration. These results indicate that PDX-1 mRNA may offer a promising approach to produce safe IPCs for clinical diabetes mellitus treatment.     

从人胚胎干细胞获得胰岛素阳性细胞的研究进展

人胚胎干细胞(hESCs)因具有无限增殖能力以及多向分化潜能,使其能为糖尿病的细胞治疗提供充足且功能完备的替代细胞。近年来,虽然有许多成功将人胚胎干细胞诱导为胰岛素阳性细胞的报道,但诱导所得的胰岛素阳性细胞仍存在很多缺陷,如效率较低,细胞功能不完备等。本文将关注人们在提高人胚胎干细胞向胰岛素阳性细胞的诱导效率及获得具有成熟β细胞功能的胰岛素阳性细胞的各种努力和尝试。