Gene transfer to induce insulin production for the treatment of diabetes mellitus

Abstract

Background: Gene transfer can induce insulin production from non-β-cells. Multiple gene transfer protocols have demonstrated efficacy correcting diabetes-associated hyperglycemia and growth abnormalities in vivo. Objectives: To review the literature reporting induction of insulin secretion from non-β-cells by gene transfer. Methods: Database search of literature in Ovid Medline. Results/conclusions: Gene transfer for the treatment of diabetes mellitus has advanced significantly, but remains premature for clinical translation. Approaches inducing metaplasia produce β-like-cells that normalize glycemia in diabetic rodents. Insulin gene transfer strategies provide somewhat inferior glycemic control, but avoid the overproduction of counter-regulatory hormones. Both approaches will require extensive investigations into their effects on host cells and tissues, and the efficacy of neither has been satisfactorily verified in a large animal model.