Stem/progenitor cells derived from adult tissues: potential for the treatment of diabetes mellitus.

In view of the recent success in pancreatic islet transplantation, interest in treating diabetes by the delivery of insulin-producing beta-cells has been renewed. Because differentiated pancreatic beta-cells cannot be expanded significantly in vitro, beta-cell stem or progenitor cells are seen as a potential source for the preparation of transplantable insulin-producing tissue. In addition to embryonic stem (ES) cells, several potential adult islet/beta-cell progenitors, derived from pancreas, liver, and bone marrow, are being studied. To date, none of the candidate cells has been fully characterized or is clinically applicable, but pancreatic physiology makes the existence of one or more types of adult islet stem cells very likely. It also seems possible that pluripotential stem cells, derived from the bone marrow, contribute to adult islet neogenesis. In future studies, more stringent criteria should be met to clonally define adult islet/beta-cell progenitor cells. If this can be achieved, the utilization of these cells for the generation of insulin-producing beta-cells in vitro seems to be feasible in the near future.