干细胞在1型糖尿病及其相关并发症治疗中的作用

L. Deb, Mia Jenkins, Malcolm Meredith, Katelyn Rennyson
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引用次数: 1

摘要

1型糖尿病(T1D)影响全球许多人,并与多种长期并发症相关。T1D的潜在病理生理涉及一个自身免疫过程,导致胰腺β-胰岛细胞的破坏,胰岛细胞是唯一负责产生身体胰岛素的细胞。因此,目前推荐的T1D治疗是胰岛素治疗,这需要全天持续的意识和监测,给患者带来了很大的压力和责任。目前正在研究各种治疗方法,以提供替代治疗,甚至是治愈方法。成人内源性祖细胞被研究为T1D患者的一种潜在治疗方法,因为除了自身免疫反应外,它们还能防止同种异体免疫反应。此外,胰腺导管细胞和骨髓干细胞是最早证明自我祖细胞可以再生胰岛细胞的研究领域之一。干细胞治疗成功的一个主要限制是移植物排斥的风险。然而,通过改变免疫细胞组成和创造物理屏障来保护植入细胞免受攻击是一种成功的解决方案,它绕过了T1D特有的有害免疫反应。这些疗法的其他限制包括畸胎瘤风险和无法在体外复制细胞分化所需的信号环境。此外,干细胞疗法在治疗糖尿病相关并发症(包括糖尿病视网膜病变、糖尿病肾病和糖尿病神经病变)方面显示出前景。本文批判性地回顾了T1D患者干细胞治疗选择的先前研究和当前进展。
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The Role of Stem Cells in the Treatment of Type 1 Diabetes Mellitus and Associated Complications
Type 1 diabetes (T1D) affects many individuals worldwide and is associated with multiple long-term complications. The underlying pathophysiology of T1D involves an autoimmune process that leads to destruction of pancreatic β-islet cells, which are the sole cells responsible for producing the body’s insulin. Thus, the current recommended treatment for T1D is insulin therapy, which requires continuous awareness and monitoring throughout the day, placing a great deal of stress and responsibility on patients. Various modalities are under investigation to provide alternatives to treatment, or even a cure. Adult endogenous progenitor cells have been studied as one potential therapy for patients with T1D due to their ability to prevent an allogenic immune response in addition to an autoimmune response. Additionally, pancreatic ductal cells and bone marrow stem cells served as one of the first areas of research that demonstrated self-progenitor cells could regenerate pancreatic islet cells. A major limitation to stem cell therapy success is the risk of graft rejection. However, altering immune cell composition and creating physical barriers to protect the implanted cells from attack has been one successful solution to this by circumventing the pernicious immune response that is characteristic of T1D. Other limitations of these therapies include teratoma risk and the inability to reproduce the required signaling environment for cell differentiation ex vivo. Furthermore, stem cell therapy has shown promise in its applications for treatment of diabetes-associated complications including diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. This article critically reviews previous research and current progress toward stem cell treatment options for patients with T1D.
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