干细胞定向分化胰岛β细胞新进展

在治疗糖尿病领域里,干细胞定向分化成胰岛β细胞是目前新颖又有前景的一种糖尿病治疗策略,不仅克服了注射胰岛素所带来的并发症,还避免了胰岛移植供体来源的短缺不足。目前供体细胞的材料主要有从胰腺中分离出的胰腺干细胞/胰腺祖细胞、胰腺导管细胞、胰腺泡细胞、肝实质细胞、小肠细胞、神经干细胞、ES细胞以及近来研究热点之一的iPS细胞。以上这些细胞都被证明或多或少具备分化成胰岛素分泌的细胞形态的潜力。在体外分化技术方面,国际上有D’Amour法、Lumelsky法等。现对干细胞定向分化胰岛β细胞的一些研究概况作简单评述。     

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。     

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.     

胰岛类器官研究进展

类器官是将具有多向分化潜能的干细胞或组织细胞在特定环境下培养分化成为能够模拟原生器官结构和功能的三维结构.类器官在各种疾病模型研究及药物筛选中发挥至关重要的作用.近年来,通过体外诱导胰腺组织或多能干细胞分化形成具有胰岛细胞功能的胰岛类器官研究成为热点,为胰岛相关疾病模型、药物研究以及糖尿病的治疗提供了新的手段.本文针对...     

诱导干细胞向胰岛β样细胞分化的研究进展

β细胞替代治疗可能是目前唯一可以治愈1型糖尿病的方法,但可供移植的胰岛来源严重匮缺,阻碍了此疗法的临床应用。为此,调控干细胞分化为成熟的有功能的胰岛细胞成为近年来的研究热点。本文着重探讨了胰岛细胞发生发育的基因调控及几种生物活性分子体外诱导干细胞向胰岛β细胞分化的作用及其机理。     

胰岛beta细胞再生研究进展

胰岛beta细胞分泌胰岛素调控体内血糖水平,胰岛beta细胞数量减少会导致糖尿病的发生。胰岛移植是目前治疗糖尿病的有效方法,但是目前仍然面临供体短缺等巨大障碍,因此研究胰岛beta细胞再生对于糖尿病的临床治疗具有深远意义。beta细胞的再生来源主要包括内源性beta细胞增殖、多能干细胞分化和其他非beta细胞的转分化。成体是否存在内源性胰腺干细胞依然是领域内亟待解决的重要科学问题之一。本文总结了与胰岛beta细胞再生相关的研究发现与进展,并讨论了内源性胰岛beta细胞增殖、诱导多能干细胞分化、非胰岛beta细胞重编程等方法在糖尿病治疗中需要注意的问题和潜在应用前景。     

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.     

干细胞研究将导致糖尿病突破

有关干细胞的研究能够提高人们对糖尿病的认识和探索新的治疗方法。ＮａｄｙａＬｕｍｅｌｓｋｙ等研究人员诱使大鼠的胚胎干细胞发育成四种能自我组合形成专一组织的细胞类型。每种类型的细胞都可分泌胰岛素和其它胰腺激素 ,并且自动生长在一起 ,形成类似胰岛的结构。通过类似于活体生物中胰岛的生理机制 ,葡萄糖引发这些细胞组合释放出有限的胰岛素干细胞研究将导致糖尿病突破@车笛     

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。     

人胰腺干细胞建系及移植诱导胰岛治疗大鼠糖尿病

供体不足已成为移植胰岛治疗Ⅰ型和部分Ⅱ型糖尿病的主要障碍,分离克隆胰腺干细胞作为种子细胞并诱导其分化为功能性胰岛可提供丰富的移植资源．本研究从人流产胎儿胰腺组织分离获得1例单克隆胰腺干细胞系．无菌取流产胎儿胰腺组织,0．1％Ⅳ型胶原酶消化分离为单个细胞和细胞团．低糖DMEM＋10％FBS培养,单个细胞和细胞团贴壁,原代上皮样胰腺干细胞克隆性生长．0．25％胰蛋白酶＋0．04％已二胺四乙酸（EDTA）消化传代,成纤维样细胞和其他细胞逐渐被消除,上皮样胰腺干细胞逐渐被纯化．克隆环筛选,获得单克隆人胰腺千细胞．在培养液中添加10ng／mL表皮生长因子（EGF）,单克隆人胰腺干细胞快速生长至单层,呈铺路石样．继续传代培养,1例来源于4月龄男性流产胎儿胰腺干细胞已传50代．液氮冷冻保存细胞1×10^9个以上．染色体核型分析,该干细胞系为正常的二倍体细胞．免疫组织化学反应,共表达pdx1,glucagon,nestin及CK19蛋白,不表达insulin,CD34,CD44及CD45．RT-PCR检测,转录pdx1,glucagon,nestin及CK19的mRNA,不转录insulin．β-巯基乙醇诱导,分化为神经细胞,免疫组织化学反应表达NF蛋白．烟酰胺诱导,分化为DTZ染色阳性,转录表达insulin,分泌insulin和C肽的功能性类胰岛．将单克隆人胰腺干细胞体外诱导胰岛移植在STZ制备的糖尿病大鼠肾囊内,能降低糖尿病大鼠血糖水平,延长寿命．     

胰高血糖素样肽1与干细胞定向分化

糖尿病已经成为21世纪严重威胁人类健康的疾病之一。胰岛移植被认为是治疗Ⅰ型和部分Ⅱ型糖尿病的最有效方法。然而,供体组织来源的匮乏限制了其应用。随着细胞移植和组织工程的日益发展,干细胞研究为新型胰岛的来源开辟了新的途径。干细胞定向诱导分化的关键是筛选合适的诱导剂以及优化诱导微环境,使干细胞培养微环境尽可能接近体内正常细胞发育分化的微环境,从而有利于干细胞适宜生长及定向分化。最近研究证实,胰高血糖素样肽1（Glucagon- Like PeptideⅠ,GLP-1）在干细胞向胰岛样细胞诱导分化中具有显著作用。因此,为了更好地应用GLP-1在干细胞定向分化中的潜能、促进应用干细胞治疗糖尿病新疗法研究的进程及干细胞定向分化技术逐渐成熟,本文就胰高血糖素样肽-1及它诱导干细胞定向分化胰岛样细胞的研究进展作一阐述。     

Stem-cell therapy for diabetes cure: how close are we?

Transplantation of insulin-producing cells offers a promising therapy to treat diabetes. However, due to the limited number of donor islet cells available, researchers are looking for different sources of pancreatic islet progenitor or stem cells. A stem cell with extensive proliferative ability may provide a valuable source of islet progenitor cells. Several studies have demonstrated that a progenitor/stem-cell population can be expanded in vitro to generate large numbers of islet progenitor cells. However, efficient and directed differentiation of these cells to an endocrine pancreatic lineage has been difficult to achieve. We discuss here various pancreatic islet stem cells that we and others have obtained from embryonic, fetal or adult human tissues. We review the progress that has been achieved with pancreatic islet progenitor cell differentiation in the last 2 decades and discuss how close we are to translate this research to the clinics.     

Stem/progenitor cells derived from adult tissues: potential for the treatment of diabetes mellitus

In view of the recent success in pancreatic islet transplantation, interest in treating diabetes by the delivery of insulin-producing beta-cells has been renewed. Because differentiated pancreatic beta-cells cannot be expanded significantly in vitro, beta-cell stem or progenitor cells are seen as a potential source for the preparation of transplantable insulin-producing tissue. In addition to embryonic stem (ES) cells, several potential adult islet/beta-cell progenitors, derived from pancreas, liver, and bone marrow, are being studied. To date, none of the candidate cells has been fully characterized or is clinically applicable, but pancreatic physiology makes the existence of one or more types of adult islet stem cells very likely. It also seems possible that pluripotential stem cells, derived from the bone marrow, contribute to adult islet neogenesis. In future studies, more stringent criteria should be met to clonally define adult islet/beta-cell progenitor cells. If this can be achieved, the utilization of these cells for the generation of insulin-producing beta-cells in vitro seems to be feasible in the near future.     

Induction of differentiation of undifferentiated cells into pancreatic beta cells in vertebrates

The beta cells of the pancreatic islets, which maintain glucose homeostasis by secreting insulin, are important cells for sustaining life. In recent years, islet transplantation has been performed as a treatment for type I diabetes. Since there are not enough donors for patients awaiting transplantation, beta cells grown in vitro are expected to be utilized as a substitute for islets. To obtain the cells with properties of human beta cells, it is necessary to understand the process by which human pancreatic islets are formed, as well as their structural characteristics. By using undifferentiated cells, such as Xenopus laevis animal caps and mouse ES cells, pancreatic tissue has shown to be able to be induced in vitro. Various attempts have been made to obtain human beta cells from human ES/iPS cells. Versatile methods have been developed and improved efficiency has been achieved by the use of low molecular weight compounds, but the challenge remains to prevent tumor formation and achieve functional maturation. Inducing the differentiation of somatic stem cells into insulin-producing cells has also brought us closer to clinical application. There are still many challenges related to the practical use of beta cells derived from undifferentiated cells, such as the development of methods to substitute these cells for host beta cells, standardization of the treatment protocol, quality control, and confirmation of safety. Research on the methods of inducing undifferentiated cells to differentiate into beta cells has shown definite progress, suggesting that cell therapy for diabetes may become a preferred therapeutic option over islet transplantation.     

Stem cell-based approaches to solving the problem of tissue supply for islet transplantation in type 1 diabetes

Type 1 diabetes is a debilitating condition, affecting millions worldwide, that is characterized by the autoimmune destruction of insulin-producing pancreatic islets of Langerhans. Although exogenous insulin administration has traditionally been the mode of treatment for this disease, recent advancements in the transplantation of donor-derived insulin-producing cells have provided new hope for a cure. However, in order for islet transplantation to become a widely used technique, an alternative source of cells must be identified to supplement the limited supply currently available from cadaveric donor organs. Stem cells represent a promising solution to this problem, and current research is being aimed at the creation of islet-endocrine tissue from these undifferentiated cells. This review presents a summary of the research to date involving stem cells and cell replacement therapy for type 1 diabetes. The potential for the differentiation of embryonic stem (ES) cells to islet phenotype is discussed, as well as the possibility of identifying and exploiting a pancreatic progenitor/stem cell from the adult pancreas. The possibility of creating new islets from adult stem cells derived from other tissues, or directly form other terminally differentiated cell types is also addressed. Finally, a model for the isolation and maturation of islets from the neonatal porcine pancreas is discussed as evidence for the existence of an islet precursor cell in the pancreas.     

间充质干细胞治疗糖尿病的研究进展

糖尿病是目前困扰人类健康的第三大杀手。胰岛移植作为糖尿病的一种有效方法早已得到公认,但是胰岛供体的缺乏和移植排斥反应的存在限制了胰岛移植的临床应用[1]。胰岛素替代疗法是目前治疗糖尿病最有效的方法。然而这种方法也有许多缺陷。间充质干细胞(mesenchymal stem cell,MSC)具有多向分化潜能的均质性细胞,具有供源丰富、易于获得、有自由供体、避免免疫排斥等优点,因而是较为理想的胰岛B细胞来源[2]。近年来,众多实验研究表明了通过诱导MSC分化为胰岛B细胞治疗糖尿病的可能性。     

WJSC 6th Anniversary Special Issues（2）:Mesenchymal stem cells Mesenchymal stem cells help pancreatic islet transplantation to control type 1 diabetes

Islet cell transplantation has therapeutic potential to treat type 1 diabetes,which is characterized by autoimmune destruction of insulin-producing pancreatic isletβcells.It represents a minimal invasive approach forβcell replacement,but long-term blood control is still largely unachievable.This phenomenon can be attributed to the lack of islet vasculature and hypoxic environment in the immediate post-transplantation period that contributes to the acute loss of islets by ischemia.Moreover,graft failures continue to occur because of immunological rejection,despite the use of potent immunosuppressive agents.Mesenchymal stem cells(MSCs)have the potential to enhance islet transplantation by suppressing inflammatory damage and immune mediated rejection.In this review we discuss the impact of MSCs on islet transplantation and focus on the potential role of MSCs in protecting islet grafts from early graft failure and from autoimmune attack.