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Current Opinion in Endocrinology, Diabetes & Obesity:
doi: 10.1097/MED.0000000000000042
DIABETES AND THE ENDOCRINE PANCREAS I: Edited by David M. Harlan

Human β-cell regeneration: progress, hurdles, and controversy

Jurczyk, Agata; Bortell, Rita; Alonso, Laura C.

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Abstract

Purpose of review

Therapies that increase functional β-cell mass may be the best long-term treatment for diabetes. Significant resources are devoted toward this goal, and progress is occurring at a rapid pace. Here, we summarize recent advances relevant to human β-cell regeneration.

Recent findings

New β-cells arise from proliferation of pre-existing β-cells or transdifferentiation from other cell types. In addition, dedifferentiated β-cells may populate islets in diabetes, possibly representing a pool of cells that could redifferentiate into functional β-cells. Advances in finding strategies to drive β-cell proliferation include new insight into proproliferative factors, both circulating and local, and elements intrinsic to the β-cell, such as cell cycle machinery and regulation of gene expression through epigenetic modification and noncoding RNAs. Controversy continues in the arena of generation of β-cells by transdifferentiation from exocrine, ductal, and alpha cells, with studies producing both supporting and opposing data. Progress has been made in redifferentiation of β-cells that have lost expression of β-cell markers.

Summary

Although significant progress has been made, and promising avenues exist, more work is needed to achieve the goal of β-cell regeneration as a treatment for diabetes.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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