ABSTRACT
Diabetes mellitus represents a serious public health problem owing to its global prevalence in the last decade. The causes of this metabolic disease include dysfunction and/or insufficient number of β cells. Existing diabetes mellitus treatments do not reverse or control the disease. Therefore, β-cell mass restoration might be a promising treatment. Several restoration approaches have been developed: inducing the proliferation of remaining insulin-producing cells, de novo islet formation from pancreatic progenitor cells (neogenesis), and converting non-β cells within the pancreas to β cells (transdifferentiation) are the most direct, simple, and least invasive ways to increase β-cell mass. However, their clinical significance is yet to be determined. Hypothetically, β cells or islet transplantation methods might be curative strategies for diabetes mellitus; however, the scarcity of donors limits the clinical application of these approaches. Thus, alternative cell sources for β-cell replacement could include embryonic stem cells, induced pluripotent stem cells, and mesenchymal stem cells. However, most differentiated cells obtained using these techniques are functionally immature and show poor glucose-stimulated insulin secretion compared with native β cells. Currently, their clinical use is still hampered by ethical issues and the risk of tumor development post transplantation. In this review, we briefly summarize the current knowledge of mouse pancreas organogenesis, morphogenesis, and maturation, including the molecular mechanisms involved. We then discuss two possible approaches of β-cell mass restoration for diabetes mellitus therapy: β-cell regeneration and β-cell replacement. We critically analyze each strategy with respect to the accessibility of the cells, potential risk to patients, and possible clinical outcomes.
Subject(s)
Humans , Animals , Mice , Diabetes Mellitus/therapy , Insulin-Secreting Cells/transplantation , Cell Culture Techniques/methods , Cell Proliferation , Cellular Reprogramming , Insulin-Secreting Cells/cytology , Islets of Langerhans Transplantation , RegenerationABSTRACT
O trabalho apresenta um relato de experiência sobre a atuação do enfermeiro num laboratório de transplante celular. Este Laboratório tem por objetivos realizar isolamentos de células produtoras de insulina para transplante em humanos. O enfermeiro como membro da equipe interdisciplinar participa da estruturação da área física, do delineamento dos processos de trabalho, da elaboração de protocolos e de programa de capacitação da equipe. As principais atividades realizadas pelo enfermeiro incluem o controle de contaminação, treinamento em serviço e avaliação da qualidade dos processos de trabalho desenvolvidos pela equipe interdisciplinar. Os resultados têm demonstrando a efetividade do trabalho do enfermeiro neste novo campo.
This article presents the experience of a nurse at a cellular transplantation laboratory. This laboratory goal is to isolate insulin producing cells for human transplantation. The nurse, as a member of an interdisciplinary team, took part in the planning of all work processes: working procedures and team training. The main activities under the nurse responsibilities include contamination control, on-the-job training and evaluation of the quality of the procedures developed by the interdisciplinary team. Results have shown the effectiveness of the nurses' work in this new field.
El presente trabajo trata de un relato de experiencia sobre la actuación del enfermero en un laboratorio de trasplante celular. El objetivo del laboratorio es realizar asilamientos de células productoras de insulina para transplante en seres humanos. El enfermero, como parte del equipo multidisciplinar tuvo participación en la estructura de todos los procesos del trabajo: elaboración de protocolos y programa de capacitación del equipo. Las principales actuaciones del enfermero incluyen el control de contaminación, entreno en el trabajo y la evaluación de la cualidad de las investigaciones hechas por el equipo multidisciplinar. Los resultados han sido favorables, enseñando la efectividad del trabajo del enfermero en esta nueva área.