The use of stem cells for pancreatic regeneration in diabetes mellitus: equally contributing authors

The endocrine pancreas represents an interesting arena for regenerative medicine and cell therapeutics. One of the major pancreatic diseases, diabetes mellitus is a metabolic disorder caused by having an insufficient number of insulin-producing beta cells. Beta-cell replenishment by cell transplantation can restore normal metabolic control. The shortage in donor pancreata has meant that the demand for transplantable beta cells has outstripped the supply, which could be met by using alternative sources of stem cells. This situation has opened up new areas of research, such as cellular reprogramming and in vivo beta-cell regeneration. Currently, embryonic stem cells or induced pluripotent stem cells seem to be the best option for clinical applications of beta-cell regeneration in the near future, as these cells have been demonstrated to represent an unlimited source of functional beta cells. Although there is compelling evidence that the adult pancreas retains regenerative capacity, it remains unclear whether this organ contains stem cells. Alternatively, specialized cell types within or outside the pancreas retain plasticity in proliferation and differentiation. Cellular reprogramming or transdifferentiation could provide a long-term solution.