Title: Stem Cell-Based Immunomodulation in Type 1 Diabetes: Beyond the Regenerative Approach
VOLUME: 17 ISSUE: 29
Author(s):Biancamaria Longoni and Franco Mosca
Affiliation:Department of Oncology, Transplantation and New Technologies in Medicine, University of Pisa, Ospedale Cisanello, Via Paradisa, 2, Pisa, Italy.
Keywords:Pancreatic islet, transplantation, autoimmunity, mesenchymal stem cells, regeneration, graft rejection, Calcium, insulin resistance, diabetes, vascular endothelial growth factor (VEGF)
Abstract: Type 1 diabetes (T1D) is an autoimmune disease, leading to pancreatic β-cell destruction and loss of glycaemic control. Administration of exogenous insulin to diabetic patients prevents life-threatening metabolic derangement, but may fail to prevent other longterm complications, such as kidney failure or diabetic retinopathy. Islet transplantation is a low-risk surgical procedure, affording improved glucose homeostasis provided sufficient islets engraft in the liver. Here we review work on the use of stem cells to generate β- cells for islet transplantation, indicating the need for improved protocols for their derivation and full maturation. We also consider recent evidence indicating that adult stem/progenitor cells may affect islet transplantation by improving the viability of engrafted islets and controlling immune reactions to islet allo- and auto-antigens, extending stem-cell use in T1D beyond the regenerative approach.
