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Stem Cell-Based Immunomodulation in Type 1 Diabetes: Beyond the Regenerative Approach

[ Vol. 17 , Issue. 29 ]

Author(s):

Biancamaria Longoni and Franco Mosca   Pages 3229 - 3242 ( 14 )

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.

Keywords:

Pancreatic islet,transplantation,autoimmunity,mesenchymal stem cells,regeneration,graft rejection,Calcium,insulin resistance,diabetes,vascular endothelial growth factor (VEGF)

Affiliation:

, Department of Oncology, Transplantation and New Technologies in Medicine, University of Pisa, Ospedale Cisanello, Via Paradisa, 2, Pisa, Italy.



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