Background. The field of cell therapy of type 1 diabetes is a particularly interesting example in the scenario of regenerative medicine. In fact, β cell replacement has its roots in the experience of islet transplantation, which began 40 years ago, and is currently a rapidly accelerating field, with several ongoing clinical trials using β cells derived from stem cells. Summary. Type 1 diabetes is particularly suitable for cell therapy as it is a disease due to the deficiency of only one cell type, the insulin-producing β cell, and this endocrine cell does not need to be positioned inside the pancreas to perform its function. On the other hand, the presence of a double immunological barrier, the allogeneic one and the autoimmune one, make the protection of β cells from rejection a major challenge. Until today, islet transplantation has taught us a lot, pioneering immunosuppressive therapies, graft encapsulation, tissue engineering, test of different implant sites and has stimulated a great variety of studies on β cell function. Nowadays, it is indeed possible to generate functional β cells from the differentiation of pluripotent stem cells and the first pioneering clinical trials with these cells are ongoing. This review starts from islet transplantation, presenting its current indications and the latest published trials to arrive at the prospects of stem cell therapy, presenting the latest innovations in the field. Key messages. The field of β cell replacement is moving forward quickly, especially thanks to all the knowledge generated by the experience of islet transplantation.


中文翻译：

---

1型糖尿病的细胞疗法：从胰岛移植到干细胞


背景。 1 型糖尿病的细胞治疗领域是再生医学领域一个特别有趣的例子。事实上，β细胞替代源于40年前开始的胰岛移植经验，目前是一个快速发展的领域，正在进行多项使用干细胞衍生的β细胞的临床试验。概括。 1 型糖尿病特别适合细胞疗​​法，因为它是一种由于仅缺乏一种细胞类型（产生胰岛素的 β 细胞）而导致的疾病，并且这种内分泌细胞不需要位于胰腺内部即可发挥其功能。另一方面，双重免疫屏障（同种异体屏障和自身免疫屏障）的存在使得保护β细胞免遭排斥成为一项重大挑战。直到今天，胰岛移植给我们带来了很多启发，开创了免疫抑制疗法、移植物封装、组织工程、不同植入部位的测试，并激发了对 β 细胞功能的大量研究。如今，确实可以通过多能干细胞的分化产生功能性β细胞，并且针对这些细胞的首次开创性临床试验正在进行中。本综述从胰岛移植开始，介绍其目前的适应症和最新发表的试验，从而得出干细胞治疗的前景，展示该领域的最新创新。 关键信息。 β细胞替代领域正在快速发展，特别是得益于胰岛移植经验所产生的所有知识。