Pathways to new β cells

Abstract

Diabetes is a leading health problem of the world and its prevalence continues to rise. With Type I diabetes, and in some patients with Type II, the lack of insulin can be counterbalanced by providing new β (insulin-producing) cells. For Type I diabetes, treating the autoimmune attack remains a serious challenge. Several strategies to produce new β cells have been proposed. These include differentiation from embryonic stem cells, proliferation of existing adult β cells, derivation fromputative adult progenitors/stem cells, and reprogramming of non-β cells to β cells. Each of these strategies has distinct merits and risks, and they are at different stages of understanding and development. In particular, the approach based on differentiation from embryonic stem cells has had strong support and in recent years has made notable progress. Nevertheless, significant hurdles remain to transform the current research into future therapies. To expedite this transformation, we believe particular emphasis should be placed on overcoming key knowledge gaps in β-cell biology, developing strategies that produce patient-specific β cells, and carefully addressing potential treatment-related complications or limitations. ©2008 Cold Spring Harbor Laboratory Press.