Human pluripotent stem cell-derived β cells: Truly immature islet β cells for type 1 diabetes therapy?

A century has passed since the Nobel Prize winning discovery of insulin, which still remains the mainstay treatment for type 1 diabetes mellitus (T1DM) to this day. True to the words of its discoverer Sir Frederick Banting, insulin is not a cure for diabetes, it is a treatment, millions of people with T1DM are dependent on daily insulin medications for life. Clinical donor islet transplantation has proven that T1DM is curable, however due to profound shortages of donor islets, it is not a mainstream treatment option for T1DM. Human pluripotent stem cell derived insulin-secreting cells, pervasively known as stem cell-derived beta cells (SC-beta cells), are a promising alternative source and have the potential to become a T1DM treatment through cell replacement therapy. Here we briefly review how islet beta cells develop and mature in vivo and several types of reported SC-beta cells produced using different ex vivo protocols in the last decade. Although some markers of maturation were expressed and glucose stimulated insulin secretion was shown, the SC-beta cells have not been directly compared to their in vivo counterparts, generally have limited glucose response, and are not yet fully matured. Due to the presence of extra-pancreatic insulin-expressing cells, and ethical and technological issues, further clarification of the true nature of these SC-beta cells is required.

Automated summary

Insulin remains the main treatment for type 1 diabetes, but it is not a cure. Stem cell-derived beta cells show potential for cell replacement therapy, but more research is needed to fully understand their nature and address technical and ethical challenges.