An Historical and Phylogenetic Perspective of Islet-Cell Development

Stem cells and diabetes treatment

Diabetes mellitus types 1 and 2 are characterized by absolute versus relative lack of insulin-producing beta cells, respectively. Reconstitution of a functional beta-cell mass by cell therapy--using organ donor islets of Langerhans--has been demonstrated to restore euglycaemia in the absence of insulin treatment. This remarkable achievement has stimulated the search for appropriate stem cell sources from which adequate expansion and maturation of therapeutic beta cells can be achieved. This recent activity is reviewed and presented with particular focus on directed differentiation from pluripotent embryonic stem cells (versus other stem/progenitor cell sources) based on knowledge from pancreatic beta-cell development and the parallel approach to controlling endogenous beta-cell neogenesis.

Gene regulatory factors in pancreatic development

The intensity of research on pancreatic development has increased markedly in the past 5 years, primarily for two reasons: we now know that the insulin-producing beta-cells normally arise from an endodermally derived, pancreas-specified precursor cell, and successful transplants of islet cells have been performed, relieving patients with type I diabetes of symptoms for extended periods after transplantation. Combining in vitro beta-cell formation from a pancreatic biopsy of a diabetic patient or from other stem-cell sources followed by endocrine cell transplantation may be the most beneficial route for a future diabetes therapy. However, to achieve this, a thorough understanding of the genetic components regulating the development of beta-cells is required. The following review discusses our current understanding of the transcription factor networks necessary for pancreatic development and how several genetic interactions coming into play at the earliest stages of endodermal development gradually help to build the pancreatic organ. Developmental Dynamics 229:176-200, 2004.