Islet cell plasticity and regeneration.

ABSTRACT

Insulin-dependent diabetes is a complex multifactorial disorder characterized by loss or dysfunction of ß-cells resulting in failure of metabolic control. Even though type 1 and 2 diabetes differ in their pathogenesis, restoring ß-cell function is the overarching goal for improved therapy of both diseases. This could be achieved either by cell-replacement therapy or by triggering intrinsic regenerative mechanisms of the pancreas. For type 1 diabetes, a combination of ß-cell replacement and immunosuppressive therapy could be a curative treatment, whereas for type 2 diabetes enhancing endogenous mechanisms of ß-cell regeneration might optimize blood glucose control. This review will briefly summarize recent efforts to allow ß-cell regeneration where the most promising approaches are currently (1) increasing ß-cell self-replication or neogenesis from ductal progenitors and (2) conversion of α-cells into ß-cells.