Genes & CellsGenes & CellsГены и КлеткиGenes and Cells2313-18292500-2562Human Stem Cells Institute12055410.23868/gc120554ArticlesСтатьиReview ArticleINSULIN-PRODUCING CELLS IN THE TREATMENT OF INSULIN-DEPENDENT DIABETES MELLITUSИнсулин-продуцирующие клетки в лечении инсулинозависимого сахарного диабетаSheremetievaM. YШереметьеваМ. Еm.e.sheremetieva@gmail.comBukharovaT. BБухароваТ. БGoldsteinD. VГольдштейнД. ВResearch Centre of Medical GeneticsМедико-генетический научный центр15032016111VOL 11, NO1 (2016)ТОМ 11, №1 (2016)243405012023Copyright ©; 2016, Eco-VectorCopyright ©; 2016, Эко-Вектор2016Eco-VectorЭко-Векторhttps://genescells.ru/2313-1829/article/view/120554

An effective treatment for insulin-dependent diabetes mellitus (DM), which provides an alternative to hormone replacement therapy, is transplantation of insulin-producing cells (IPCs). Donor β-cells are transplanted both in the form of a complete pancreas, or in the form of isolated islets of Langerhans. However, the application of this method is limited due to the lack of donor material and the need for lifelong immunosuppressive therapy that has a detrimental impact on the weakened DM patient's body. An alternative method of obtaining IPCs is to differentiate stem or progenitor cells. Pancreatic differentiation capability has been demonstrated for various types of stem cells Currently, induced pluripotent stem cell IPSC) are considered to be the most promising source of IPCs, including those obtained from mature cells of the patients themselves Firstly, such IPCs can be gained in unlimited quantities. Secondly, in the case of autologous transplantation they are least exposed to the recipient body's immune attack, thereby making it possible to completely discard immunosuppressive therapy. IPSCs introduction into clinical practice is hindered by the fact that they provoke the formation of teratomas in the recipient>s body. Moreover, they retain this ability even after differentiation because of a number of undifferentiated cells preserved in the population This review focuses on contemporary protocols for obtaining IPCs from IPSCs. These protocols mimic β-cells formation stages during embryonic development. The review also covers the application of IPC immuno-isolating containers for transplantation. Their semipermeable walls, on the one hand, protect the transplant from the recipient>s immune system, and on the other hand, they suppress the risk of the transplant causing tumor formation. in addition, attention will be paid to the use of IPCs derived from IPSCs as a model object for studying the processes occurring in β-cells at normal circumstances as well as during DM.

Эффективным методом лечения инсулинозависимого сахарного диабета, альтернативным гормонозаместительной терапии, является трансплантация инсулин-продуцирующих клеток (ИПК). Донорские β-клетки трансплантируются как в составе поджелудочной железы целиком, так и в виде изолированных островков Лангерганса. Однако применение метода ограничено недостатком донорского материала и необходимостью проведения пожизненной иммуносупрессивной терапии, пагубно сказывающейся на состоянии ослабленного организма больных диабетом . Альтернативный способ получения ИПК - дифференцировка из стволовых или прогениторных клеток. Способность к панкреатической дифференцировке выявлена у различных типов стволовых клеток В настоящее время в качестве наиболее перспективного источника ИПК рассматривают индуцированные плюрипотентные стволовые клетки (ИПСК), включая те, которые получены из специализированных клеток самих пациентов. Такие ИПК, во-первых, могут быть получены в неограниченном количестве, а во-вторых, в случае аутогенной трансплантации в наименьшей степени подвергаются иммунной атаке со стороны реципиентов, тем самым давая возможность полностью отказаться от иммуносупрессивной терапии Внедрению ИПСК в клиническую практику препятствует то, что они способны провоцировать образование тератом в организме реципиентов, причём сохраняют эту способность даже после дифференцировки за счёт отдельных недифференцированных клеток, сохранившихся в популяции Данный обзор посвящён современным протоколам получения ИПК из ИПСК, воспроизводящим этапы формирования β-клеток при эмбриональном развитии. Рассмотрено применение для трансплантации ИПК иммунноизолирующих контейнеров, полупроницаемые стенки которых, с одной стороны, защищают трансплантат от воздействия иммунной системы реципиента, а с другой, обеспечивают безопасность трансплантата для реципиента с точки зрения образования опухолей Описано использование ИПК, полученных из ИПСК, в качестве модельного объекта для изучения процессов, происходящих в β-клетках в норме и при сахарном диабете

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