Endocrinol Metab.  2024 Apr;39(2):191-205. 10.3803/EnM.2023.1910.

Scaling Insulin-Producing Cells by Multiple Strategies

• Choi J
• Cayabyab F
• Perez H
• Yoshihara E

• KMID: 2554625
• DOI: http://doi.org/10.3803/EnM.2023.1910

Abstract

In the quest to combat insulin-dependent diabetes mellitus (IDDM), allogenic pancreatic islet cell therapy sourced from deceased donors represents a significant therapeutic advance. However, the applicability of this approach is hampered by donor scarcity and the demand for sustained immunosuppression. Human induced pluripotent stem cells are a game-changing resource for generating synthetic functional insulin-producing β cells. In addition, novel methodologies allow the direct expansion of pancreatic progenitors and mature β cells, thereby circumventing prolonged differentiation. Nevertheless, achieving practical reproducibility and scalability presents a substantial challenge for this technology. As these innovative approaches become more prominent, it is crucial to thoroughly evaluate existing expansion techniques with an emphasis on their optimization and scalability. This manuscript delineates these cutting-edge advancements, offers a critical analysis of the prevailing strategies, and underscores pivotal challenges, including cost-efficiency and logistical issues. Our insights provide a roadmap, elucidating both the promises and the imperatives in harnessing the potential of these cellular therapies for IDDM.

Keyword

Diabetes mellitus; Islet transplantation; Stem cells; Cell expansion; Mitogens; Cryopreservation