Abstract:
Diabetes is one of the major diseases and concerns of public health systems that affects over 200 million patients worldwide. It is estimated that 90% of these patients suffer from diabetes type 2, while 10% present diabetes type 1. This type of diabetes and certain types of diabetes type 2, are characterized by dysregulation of blood glycemic levels due to the total or partial depletion of insulin-secreting pancreatic β-cells. Different approaches have been proposed for long-term treatment of insulin-dependent patients; amongst them, cell-based approaches have been the subject of basic and clinical research since they allow blood glucose level sensing and in situ insulin secretion. The current gold standard for insulin-dependent patients is on-demand exogenous insulin application; cell-based therapies aim to remove this burden from the patient and caregivers. In recent years, protocols to isolate and implant pancreatic islets from diseased donors have been developed and tested in clinical trials. Nevertheless, the shortage of donors, along with the need of immunosuppressive companion therapies, have pushed researchers to focus their attention and efforts to overcome these disadvantages and develop alternative strategies. This review discusses current tested clinical approaches and future potential alternatives for diabetes type 1, and some diabetes type 2, insulin-dependent patients. Additionally, advantages and disadvantages of these discussed methods.
摘要:
糖尿病是公共卫生系统的主要疾病和关注之一,影响全球超过2亿患者。据估计,这些患者中有90%患有2型糖尿病,而10%患有1型糖尿病。这种类型的糖尿病和某些类型的2型糖尿病的特征在于由于分泌胰岛素的胰腺β细胞的全部或部分消耗而导致的血糖水平的失调。已经提出了不同的方法来长期治疗胰岛素依赖型患者;其中,基于细胞的方法一直是基础和临床研究的主题,因为它们允许血糖水平感测和原位胰岛素分泌。胰岛素依赖型患者的当前黄金标准是按需外源性胰岛素应用;基于细胞的疗法旨在消除患者和护理人员的这种负担。近年来,已经开发了从患病供体分离和植入胰岛的方案,并在临床试验中进行了测试。然而,捐助者的短缺,随着免疫抑制伴侣疗法的需要,促使研究人员集中注意力和努力克服这些缺点,并制定替代策略。这篇综述讨论了1型糖尿病和一些2型糖尿病胰岛素依赖型患者的当前经过测试的临床方法和未来的潜在替代方案。此外,这些讨论方法的优缺点。