Cell therapy for diabetes mellitus

The number of diabetic patients in the world is increasing in recent years and the prevention of diabetes mellitus is therefore one of the urgent medical issues. Exogenous insulin is used for the control of blood glucose in diabetic patients; however, hypoglycemic episodes are unavoidable. Over the last several decades, islet transplantation has been developed as a promising method to achieve strict control of blood glucose and a potential cure for type 1 diabetes. However, due to the shortage of donor pancreata, alternative sources of islets have been sought through the generation of beta cells from stem cells, use of porcine islets, and beta cell expansion with growth factors. However, differentiation and expansion of embryonic and pancreatic stem cells and expansion of differentiated beta cells in vitro is limited. Expansion of primary beta cells by growth factors is also hampered by the senescence of the cells. Thus, we focused on establishing a human pancreatic beta cell line that is functionally equivalent to primary beta cells and can yield large amounts of cells for transplantation. Using Cre/loxP-based reversible immortalization, we constructed a reversibly immortalized pancreatic beta cell clone (NAKT-15). The cells may overcome the limitation of primary pancreatic beta cells for transplantation to control type 1 diabetes. In order to avoid the use of immunosuppressive agents, we are currently engaged in developing an implantable bag-type bioartificial pancreas. In this article, I discuss the hurdles of the current therapy for diabetes and introduce the possible future treatment of diabetes.