β-Cells from Embryonic and Adult Stem Cells and Progenitors

Diabetes is a chronic autoimmune disease, causing the destruction of the insulin-producing β-cells of the pancreatic islet and leading to glycemic dysregulation. Exogenous insulin administration and glucose testing moderately rectifies hyperglycemia, but does not provide adequate fine tuning necessary for complete prevention of hypoglycemia acutely, nor micro- and macro-vascular complications in the long-term. Islet transplants have shown great promise for this dynamic glucose regulation, but a shortage of cadaveric-sourced cells, and lifelong immune suppression requirements vastly restrict this technique from being widely available to patients with the disease. Therefore alternative sources of insulin-producing cells are needed. In this chapter, the role of stem cell biology in the current context of diabetes therapy is discussed, including an assessment of human embryonic and human induced pluripotent stem cells for the restoration of β-cell mass. Additionally, the existence of putative resident stem cells, and possible fluidity in lineage fate determination within endocrine pancreas- related cell types is examined.

Keywords: β-cell, Diabetes, Pancreas, Plasticity, Progenitor cell, Regeneration, Stem cell.