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

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

Current Opinion in Endocrinology, Diabetes and Obesity: April 2014 - Volume 21 - Issue 2 - p 102–108
doi: 10.1097/MED.0000000000000042

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.

University of Massachusetts Medical School, Diabetes Center of Excellence, Worcester, Massachusetts, USA

Correspondence to Laura Alonso, University of Massachusetts Medical School, Diabetes Division, 368 Plantation Street, Worcester, MA 01605, USA. Tel: +1 774 455 3640; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins