[New frontiers for the therapy of insulin-dependent diabetes mellitus]

Introduction of new analogic insulin molecules has favorably impacted control of hyperglycemia with positive effects on onset and severity of chronic complications of the T1DM. However, insulin therapy does not represent a cure for the disease. On the contrary, cell therapy, by substituting diseased tissue with fresh vital cells, whether be they graft of whole pancreas or isolated islets of Langerhans, might provide for a cure for T1DM. However, the restricted availability of cadaveric human donors, coupled with recipient's pharmacologic immunosuppression, strictly hamper the diffusion of this approach. Protecting the isolated islets within microcapsules developed in our laboratory, with no recipient's immunosuppression, may represent a major problem-solving alley. Microcapsules might also offer the opportunity to provide non human tissue as a resource for donor islets thereby circumventing the restrictions in human islet tissue procurement. On another research front, re-activating progenitor cells that may reconstitute original viable and functional beta-cells, within an endocrine pancreas regenerative system, while autoimmunity is being abrogated by engineering the host's immune system, could provide a radical solution to the problem posed by T1DM.