Pancreatic islet cell therapy for type I diabetes: understanding the effects of glucose stimulation on islets in order to produce better islets for transplantation

Jiaqiang Ren¹ , Ping Jin¹ , Ena Wang¹ , Eric Liu² , David M Harlan² , Xin Li¹ and David F Stroncek¹

¹Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA

²National Institute of Diabetes, Digestive and Kidney Disease, National Institutes of Health, Bethesda, MD, 20892, USA

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Journal of Translational Medicine 2007, 5:1doi:10.1186/1479-5876-5-1


Published:	3 January 2007

Abstract

While insulin replacement remains the cornerstone treatment for type I diabetes mellitus (T1DM), the transplantation of pancreatic islets of Langerhans has the potential to become an important alternative. And yet, islet transplant therapy is limited by several factors, including far too few donor pancreases. Attempts to expand mature islets or to produce islets from stem cells are far from clinical application. The production and expansion of the insulin-producing cells within the islet (so called β cells), or even creating cells that secrete insulin under appropriate physiological control, has proven difficult. The difficulty is explained, in part, because insulin synthesis and release is complex, unique, and not entirely characterized. Understanding β-cell function at the molecular level will likely facilitate the development of techniques to manufacture β-cells from stem cells. We will review islet transplantation, as well as the mechanisms underlying insulin transcription, translation and glucose stimulated insulin release.