Diabetes Mellitus and iPSC-Based Therapy

Abstract

At present, the number of diabetes mellitus (DM) patients has exceeded 537 million worldwide, and this number continues to increase. Type 1 diabetes (T1D) is caused by the autoimmune destruction of p-cells, whereas type 2 diabetes (T2D) is caused by a hostile metabolic environment that leads to p-cell exhaustion and dysfunction. The prevalence of DM type 1 and type 2 is widespread and results in fatality without treatment. As of now, first-line medications for diabetes address hyperglycemia and insulin resistance. Owing to this, there is a need to develop advanced therapies that can either protect or replace lost p-cells with stem-cellderived p-like cells or engineered islet-like clusters. Recently, stem cells (SCs) have been considered to be renewable cell sources in the treatment of diabetes and the development of insulin-producing cells. Clinicians used adult mesenchymal stem cells (Lavinsky et al., Proceedings of the National Academy of Sciences of the United States of America 95:2920-5, 1998) and embryonic stem cells (ESC) to improve patients’ condition; however, they faced ethical challenges and the danger of developing tumors in patients. Induced pluripotent stem cell (iPSC)-based genetically modified stem cell therapy is the way to fix these problems, together with diabetes medicines available now. Patient- or disease-specific cell lines are permitted under iPSC. An improved iPSC or SC-islet differentiation generates cells that secrete insulin, which makes it possible for autologous diabetic cell replacement and disease modeling in vitro. As SC-islets are limitless, they can be used for individualized therapy and to overcome the drawbacks of donor islets. Therefore, this chapter focuses on the potential of islet engineering, diabetes cells, and their therapeutic potential among the iPSC-derived progenitors. These studies on stem cells and regenerative medicine may result in new treatments for diabetes.