Expanding human beta cells

Excerpt

To the Editor: An understanding of how beta cell number is regulated during normal life and regeneration is crucial not only from a cognitive point of view, but also forms a basis for the development of new strategies to treat or cure diabetic patients. Beta cell homeostasis is the balance between beta cell formation and death. Beta cells can be formed by neogenesis from non-beta cells (differentiation from progenitors, transdifferentiation from exocrine cells) or by the proliferation of beta cells already present in the pancreas. For a long time, it was thought that the rate of beta cell proliferation was extremely low and played a minor role in beta cell expansion occurring during adult life. This hypothesis was convincingly challenged by lineage-based approaches demonstrating that, during physiological adult life, newly formed beta cells are derived from pre-existing beta cells [1]. This important finding led to a large number of teams entering the field of beta cell proliferation, which produced major new information and a better understanding of this important topic [2]. It is thus now proposed that strategies that would enhance beta cell proliferation can be used to develop human endocrine cells in large quantities to be used for diabetes therapy in humans. However, it should be kept in mind that the vast majority of the recent data on beta cell proliferation are derived from rodent models. Thus, in my view, a major question is: is the recent information demonstrating the major role of beta cell proliferation in the rodent true for human beta cells? …