Regenerating ß cells of the pancreas - potential developments in diabetes treatment.

ABSTRACT

INTRODUCTION: The etiology of diabetes is mainly attributed to insulin deficiency due to the lack of ß cells (type 1), or to insulin resistance that eventually results in ß cell dysfunction (type 2). Therefore, an ultimate cure for diabetes requires the ability to replace the lost insulin-secreting ß cells. Strategies for regenerating ß cells are under extensive investigation. AREAS COVERED Herein, the authors first summarize the mechanisms underlying embryonic ß cell development and spontaneous adult ß cell regeneration, which forms the basis for developing ß cell regeneration strategies. Then the rationale and progress of each ß cell regeneration strategy is reviewed. Current ß cell regeneration strategies can be classified into two main categories in vitro ß cell regeneration using pluripotent stem cells and in vivo reprogramming of non-ß cells into ß cells. Each has its own advantages and disadvantages. EXPERT OPINION Regenerating ß cells has shown its potential as a cure for the treatment of insulin-deficient diabetes. Much progress has been made, and ß cell regeneration therapy is getting closer to a clinical reality. Nevertheless, more hurdles need to be overcome before any of the strategies suggested can be fully translated from bench to bedside.