De la biologie du développement à la thérapie cellulaire du diabète

Valérie Schreiber (1) , Gérard Gradwohl (1)

1 IGBMC - Institut de Génétique et de Biologie Moléculaire et Cellulaire

The generation of pancreatic beta cells from pluripotent stem cells would provide an unlimited source of insulin-secreting cells for the treatment of type 1 diabetes. To this end, the molecular and cellular mechanisms that control the formation of beta cells during embryogenesis, when beta cells are born, were finely dissected. Thus, by mimicking the development of beta cells, it has been possible to generate insulin-secreting cells in vitro from pluripotent stem cells. Recent and encouraging clinical trials suggest that the transplantation of stem cell derived pancreatic cells makes it possible to reduce the insulin requirements of treated patients. Despite recent advances in differentiation protocols, insulin-secreting cells generated in vitro are still physiologically different from primary beta cells and the conditions for their functional maturation in vitro remain to be identified. Future developments could be the generation and transplantation of entire, stem cell derived, pancreatic islets which could improve the functionality of islets cells in the control of glycemia. Finally, it will be important to find the means to protect the transplanted cells from their destruction by the immune system while ensuring their vascularization. In conclusion, it seems possible that the transplantation of insulin-secreting cells produced from pluripotent stem cells constitutes, in the future, an alternative to the transplantation of cadaveric islets in type 1 diabetes.

Mots clés: diabète; cellule beta; cellules souches pluripotentes

Domaines: Sciences du Vivant [q-bio]

Valérie Schreiber, Gérard Gradwohl. De la biologie du développement à la thérapie cellulaire du diabète. Médecine des Maladies Métaboliques, A paraître, ⟨10.1016/j.mmm.2023.05.009⟩. ⟨hal-04124672⟩