Stammzellen für die Wiederherstellung der endogenen Insulinsekretion

Abstract

Despite modern insulin therapies, there are patients whose diabetes is not well controlled. Such patients suffer from hypoglycaemic episodes and are at high risk of developing late diabetic complications. Restoring endogenous insulin production by transplantation of pancreatic islets is therefore an important clinical goal. However, the necessary immunosuppression and the limited availability of suitable human donor material limit widespread application. Diabetes research has therefore been trying for many years to generate insulin-producing cells from stem cells (SC) in order to no longer be dependent on donor organs. Embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) can be used for this purpose. As iPSCs are reprogrammed from adult cells, they are therefore not subject to ethical concerns. In principle, the derivation, propagation, and differentiation of ESCs and iPSCs are already possible on a large scale today. However, there are also problems, such as the development of tumours through transplanted SCs that have remained undifferentiated or iPSCs that have not been completely reprogrammed. While research is still working on these and other challenges, iPSCs already allow the generation of patient- and disease-specific cell lines. This overview explains the biological background, the resulting clinical potential of ESCs and iPSCs, and the current state of clinical stem cell therapy of diabetes mellitus.