Skip to main content
Erschienen in: Diabetologia 2/2012

01.02.2012 | Article

The functional and molecular characterisation of human embryonic stem cell-derived insulin-positive cells compared with adult pancreatic beta cells

verfasst von: C. L. Basford, K. J. Prentice, A. B. Hardy, F. Sarangi, S. J. Micallef, X. Li, Q. Guo, A. G. Elefanty, E. G. Stanley, G. Keller, E. M. Allister, M. C. Nostro, M. B. Wheeler

Erschienen in: Diabetologia | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

Abstract

Aims/hypothesis

Using a novel directed differentiation protocol, we recently generated up to 25% insulin-producing cells from human embryonic stem cells (hESCs) (insulin+ cells). At this juncture, it was important to functionally and molecularly characterise these hESC-derived insulin+ cells and identify key differences and similarities between them and primary beta cells.

Methods

We used a new reporter hESC line with green fluorescent protein (GFP) cDNA targeted to the INS locus by homologous recombination (INS GFP/w ) and an untargeted hESC line (HES2). INS GFP/w allowed efficient identification and purification of GFP-producing (INS:GFP+) cells. Insulin+ cells were examined for key features of adult beta cells using microarray, quantitative PCR, secretion assays, imaging and electrophysiology.

Results

Immunofluorescent staining showed complete co-localisation of insulin with GFP; however, cells were often multihormonal, many with granules containing insulin and glucagon. Electrophysiological recordings revealed variable KATP and voltage-gated Ca2+ channel activity, and reduced glucose-induced cytosolic Ca2+ uptake. This translated into defective glucose-stimulated insulin secretion but, intriguingly, appropriate glucagon responses. Gene profiling revealed differences in global gene expression between INS:GFP+ cells and adult human islets; however, INS:GFP+ cells had remarkably similar expression of endocrine-lineage transcription factors and genes involved in glucose sensing and exocytosis.

Conclusions/interpretation

INS:GFP+ cells can be purified from differentiated hESCs, providing a superior source of insulin-producing cells. Genomic analyses revealed that INS:GFP+ cells collectively resemble immature endocrine cells. However, insulin+ cells were heterogeneous, a fact that translated into important functional differences within this population. The information gained from this study may now be used to generate new iterations of functioning beta cells that can be purified for transplant.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Shapiro AM, Lakey JR, Ryan EA et al (2000) Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med 343:230–238PubMedCrossRef Shapiro AM, Lakey JR, Ryan EA et al (2000) Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med 343:230–238PubMedCrossRef
2.
Zurück zum Zitat Correa-Giannella ML, Raposo do Amaral AS (2009) Pancreatic islet transplantation. Diabetol Metab Syndr 1:9PubMedCrossRef Correa-Giannella ML, Raposo do Amaral AS (2009) Pancreatic islet transplantation. Diabetol Metab Syndr 1:9PubMedCrossRef
3.
Zurück zum Zitat Chen S, Borowiak M, Fox JL et al (2009) A small molecule that directs differentiation of human ESCs into the pancreatic lineage. Nat Chem Biol 5:258–265PubMedCrossRef Chen S, Borowiak M, Fox JL et al (2009) A small molecule that directs differentiation of human ESCs into the pancreatic lineage. Nat Chem Biol 5:258–265PubMedCrossRef
4.
Zurück zum Zitat Jiang J, Au M, Lu K et al (2007) Generation of insulin-producing islet-like clusters from human embryonic stem cells. Stem Cells 25:1940–1953PubMedCrossRef Jiang J, Au M, Lu K et al (2007) Generation of insulin-producing islet-like clusters from human embryonic stem cells. Stem Cells 25:1940–1953PubMedCrossRef
5.
Zurück zum Zitat Jiang W, Shi Y, Zhao D et al (2007) In vitro derivation of functional insulin-producing cells from human embryonic stem cells. Cell Res 17:333–344PubMedCrossRef Jiang W, Shi Y, Zhao D et al (2007) In vitro derivation of functional insulin-producing cells from human embryonic stem cells. Cell Res 17:333–344PubMedCrossRef
6.
Zurück zum Zitat Mfopou JK, Chen B, Mateizel I, Sermon K, Bouwens L (2010) Noggin, retinoids, and fibroblast growth factor regulate hepatic or pancreatic fate of human embryonic stem cells. Gastroenterology 138:2233–2245PubMedCrossRef Mfopou JK, Chen B, Mateizel I, Sermon K, Bouwens L (2010) Noggin, retinoids, and fibroblast growth factor regulate hepatic or pancreatic fate of human embryonic stem cells. Gastroenterology 138:2233–2245PubMedCrossRef
7.
Zurück zum Zitat Zhang D, Jiang W, Shi Y, Deng H (2009) Generation of pancreatic islet cells from human embryonic stem cells. Sci China C Life Sci 52:615–621PubMedCrossRef Zhang D, Jiang W, Shi Y, Deng H (2009) Generation of pancreatic islet cells from human embryonic stem cells. Sci China C Life Sci 52:615–621PubMedCrossRef
8.
Zurück zum Zitat D'Amour KA, Bang AG, Eliazer S et al (2006) Production of pancreatic hormone-expressing endocrine cells from human embryonic stem cells. Nat Biotechnol 24:1392–1401PubMedCrossRef D'Amour KA, Bang AG, Eliazer S et al (2006) Production of pancreatic hormone-expressing endocrine cells from human embryonic stem cells. Nat Biotechnol 24:1392–1401PubMedCrossRef
9.
Zurück zum Zitat Kroon E, Martinson LA, Kadoya K et al (2008) Pancreatic endoderm derived from human embryonic stem cells generates glucose-responsive insulin-secreting cells in vivo. Nat Biotechnol 26:443–452PubMedCrossRef Kroon E, Martinson LA, Kadoya K et al (2008) Pancreatic endoderm derived from human embryonic stem cells generates glucose-responsive insulin-secreting cells in vivo. Nat Biotechnol 26:443–452PubMedCrossRef
10.
Zurück zum Zitat Matveyenko AV, Georgia S, Bhushan A, Butler PC (2010) Inconsistent formation and nonfunction of insulin-positive cells from pancreatic endoderm derived from human embryonic stem cells in athymic nude rats. Am J Physiol Endocrinol Metab 299:E713–E720PubMedCrossRef Matveyenko AV, Georgia S, Bhushan A, Butler PC (2010) Inconsistent formation and nonfunction of insulin-positive cells from pancreatic endoderm derived from human embryonic stem cells in athymic nude rats. Am J Physiol Endocrinol Metab 299:E713–E720PubMedCrossRef
11.
Zurück zum Zitat Nostro MC, Sarangi F, Ogawa S et al (2011) Stage-specific signaling through TGFbeta family members and WNT regulates patterning and pancreatic specification of human pluripotent stem cells. Development 138:861–871PubMedCrossRef Nostro MC, Sarangi F, Ogawa S et al (2011) Stage-specific signaling through TGFbeta family members and WNT regulates patterning and pancreatic specification of human pluripotent stem cells. Development 138:861–871PubMedCrossRef
12.
Zurück zum Zitat Hardy AB, Fox JE, Giglou PR et al (2009) Characterization of Erg K+ channels in alpha- and beta-cells of mouse and human islets. J Biol Chem 284:30441–30452PubMedCrossRef Hardy AB, Fox JE, Giglou PR et al (2009) Characterization of Erg K+ channels in alpha- and beta-cells of mouse and human islets. J Biol Chem 284:30441–30452PubMedCrossRef
13.
Zurück zum Zitat Smukler SR, Arntfield ME, Razavi R et al (2011) The adult mouse and human pancreas contain rare multipotent stem cells that express insulin. Cell Stem Cell 8:281–293PubMedCrossRef Smukler SR, Arntfield ME, Razavi R et al (2011) The adult mouse and human pancreas contain rare multipotent stem cells that express insulin. Cell Stem Cell 8:281–293PubMedCrossRef
14.
Zurück zum Zitat Diao J, Allister EM, Koshkin V et al (2008) UCP2 is highly expressed in pancreatic alpha-cells and influences secretion and survival. Proc Natl Acad Sci USA 105:12057–12062PubMedCrossRef Diao J, Allister EM, Koshkin V et al (2008) UCP2 is highly expressed in pancreatic alpha-cells and influences secretion and survival. Proc Natl Acad Sci USA 105:12057–12062PubMedCrossRef
15.
Zurück zum Zitat Lyttle BM, Li J, Krishnamurthy M et al (2008) Transcription factor expression in the developing human fetal endocrine pancreas. Diabetologia 51:1169–1180PubMedCrossRef Lyttle BM, Li J, Krishnamurthy M et al (2008) Transcription factor expression in the developing human fetal endocrine pancreas. Diabetologia 51:1169–1180PubMedCrossRef
16.
Zurück zum Zitat Nicolson TJ, Bellomo EA, Wijesekara N et al (2009) Insulin storage and glucose homeostasis in mice null for the granule zinc transporter ZnT8 and studies of the type 2 diabetes-associated variants. Diabetes 58:2070–2083PubMedCrossRef Nicolson TJ, Bellomo EA, Wijesekara N et al (2009) Insulin storage and glucose homeostasis in mice null for the granule zinc transporter ZnT8 and studies of the type 2 diabetes-associated variants. Diabetes 58:2070–2083PubMedCrossRef
17.
Zurück zum Zitat Lu H, Koshkin V, Allister EM, Gyulkhandanyan AV, Wheeler MB (2010) Molecular and metabolic evidence for mitochondrial defects associated with beta-cell dysfunction in a mouse model of type 2 diabetes. Diabetes 59:448–459PubMedCrossRef Lu H, Koshkin V, Allister EM, Gyulkhandanyan AV, Wheeler MB (2010) Molecular and metabolic evidence for mitochondrial defects associated with beta-cell dysfunction in a mouse model of type 2 diabetes. Diabetes 59:448–459PubMedCrossRef
18.
Zurück zum Zitat Wijesekara N, Dai FF, Hardy AB et al (2010) Beta cell-specific Znt8 deletion in mice causes marked defects in insulin processing, crystallisation and secretion. Diabetologia 53:1656–1668PubMedCrossRef Wijesekara N, Dai FF, Hardy AB et al (2010) Beta cell-specific Znt8 deletion in mice causes marked defects in insulin processing, crystallisation and secretion. Diabetologia 53:1656–1668PubMedCrossRef
19.
Zurück zum Zitat Tam P, Mahfoud R, Nutikka A et al (2008) Differential intracellular transport and binding of verotoxin 1 and verotoxin 2 to globotriaosylceramide-containing lipid assemblies. J Cell Physiol 216:750–763PubMedCrossRef Tam P, Mahfoud R, Nutikka A et al (2008) Differential intracellular transport and binding of verotoxin 1 and verotoxin 2 to globotriaosylceramide-containing lipid assemblies. J Cell Physiol 216:750–763PubMedCrossRef
20.
Zurück zum Zitat Leung YM, Ahmed I, Sheu L et al (2005) Electrophysiological characterization of pancreatic islet cells in the mouse insulin promoter-green fluorescent protein mouse. Endocrinology 146:4766–4775PubMedCrossRef Leung YM, Ahmed I, Sheu L et al (2005) Electrophysiological characterization of pancreatic islet cells in the mouse insulin promoter-green fluorescent protein mouse. Endocrinology 146:4766–4775PubMedCrossRef
21.
22.
Zurück zum Zitat D'Amour KA, Agulnick AD, Eliazer S, Kelly OG, Kroon E, Baetge EE (2005) Efficient differentiation of human embryonic stem cells to definitive endoderm. Nat Biotechnol 23:1534–1541PubMedCrossRef D'Amour KA, Agulnick AD, Eliazer S, Kelly OG, Kroon E, Baetge EE (2005) Efficient differentiation of human embryonic stem cells to definitive endoderm. Nat Biotechnol 23:1534–1541PubMedCrossRef
23.
Zurück zum Zitat Van Hoof D, D'Amour KA, German MS (2009) Derivation of insulin-producing cells from human embryonic stem cells. Stem Cell Res 3:73–87PubMedCrossRef Van Hoof D, D'Amour KA, German MS (2009) Derivation of insulin-producing cells from human embryonic stem cells. Stem Cell Res 3:73–87PubMedCrossRef
24.
Zurück zum Zitat Du A, Hunter CS, Murray J et al (2009) Islet-1 is required for the maturation, proliferation, and survival of the endocrine pancreas. Diabetes 58:2059–2069PubMedCrossRef Du A, Hunter CS, Murray J et al (2009) Islet-1 is required for the maturation, proliferation, and survival of the endocrine pancreas. Diabetes 58:2059–2069PubMedCrossRef
25.
Zurück zum Zitat Aguilar-Bryan L, Bryan J, Nakazaki M (2001) Of mice and men: K(ATP) channels and insulin secretion. Recent Prog Horm Res 56:47–68PubMedCrossRef Aguilar-Bryan L, Bryan J, Nakazaki M (2001) Of mice and men: K(ATP) channels and insulin secretion. Recent Prog Horm Res 56:47–68PubMedCrossRef
26.
Zurück zum Zitat Gopel S, Zhang Q, Eliasson L et al (2004) Capacitance measurements of exocytosis in mouse pancreatic alpha-, beta- and delta-cells within intact islets of Langerhans. J Physiol 556:711–726PubMedCrossRef Gopel S, Zhang Q, Eliasson L et al (2004) Capacitance measurements of exocytosis in mouse pancreatic alpha-, beta- and delta-cells within intact islets of Langerhans. J Physiol 556:711–726PubMedCrossRef
27.
Zurück zum Zitat Satin LS (2000) Localized calcium influx in pancreatic beta-cells: its significance for Ca2+-dependent insulin secretion from the islets of Langerhans. Endocrine 13:251–262PubMedCrossRef Satin LS (2000) Localized calcium influx in pancreatic beta-cells: its significance for Ca2+-dependent insulin secretion from the islets of Langerhans. Endocrine 13:251–262PubMedCrossRef
28.
Zurück zum Zitat Schuit FC (1996) Factors determining the glucose sensitivity and glucose responsiveness of pancreatic beta cells. Horm Res 46:99–106PubMedCrossRef Schuit FC (1996) Factors determining the glucose sensitivity and glucose responsiveness of pancreatic beta cells. Horm Res 46:99–106PubMedCrossRef
29.
Zurück zum Zitat Wang Z, Thurmond DC (2009) Mechanisms of biphasic insulin-granule exocytosis—roles of the cytoskeleton, small GTPases and SNARE proteins. J Cell Sci 122:893–903PubMedCrossRef Wang Z, Thurmond DC (2009) Mechanisms of biphasic insulin-granule exocytosis—roles of the cytoskeleton, small GTPases and SNARE proteins. J Cell Sci 122:893–903PubMedCrossRef
30.
Zurück zum Zitat Rezania A, Riedel MJ, Wideman RD et al (2010) Production of functional glucagon-secreting alpha cells from human embryonic stem cells. Diabetes 60:239–247PubMedCrossRef Rezania A, Riedel MJ, Wideman RD et al (2010) Production of functional glucagon-secreting alpha cells from human embryonic stem cells. Diabetes 60:239–247PubMedCrossRef
31.
Zurück zum Zitat Petri A, Ahnfelt-Ronne J, Frederiksen KS et al (2006) The effect of neurogenin3 deficiency on pancreatic gene expression in embryonic mice. J Mol Endocrinol 37:301–316PubMedCrossRef Petri A, Ahnfelt-Ronne J, Frederiksen KS et al (2006) The effect of neurogenin3 deficiency on pancreatic gene expression in embryonic mice. J Mol Endocrinol 37:301–316PubMedCrossRef
32.
Zurück zum Zitat Pirila E, Ramamurthy NS, Sorsa T, Salo T, Hietanen J, Maisi P (2003) Gelatinase A (MMP-2), collagenase-2 (MMP-8), and laminin-5 gamma2-chain expression in murine inflammatory bowel disease (ulcerative colitis). Dig Dis Sci 48:93–98PubMedCrossRef Pirila E, Ramamurthy NS, Sorsa T, Salo T, Hietanen J, Maisi P (2003) Gelatinase A (MMP-2), collagenase-2 (MMP-8), and laminin-5 gamma2-chain expression in murine inflammatory bowel disease (ulcerative colitis). Dig Dis Sci 48:93–98PubMedCrossRef
33.
Zurück zum Zitat Aye T, Toschi E, Sharma A, Sgroi D, Bonner-Weir S (2010) Identification of markers for newly formed beta-cells in the perinatal period: a time of recognized beta-cell immaturity. J Histochem Cytochem 58:369–376PubMedCrossRef Aye T, Toschi E, Sharma A, Sgroi D, Bonner-Weir S (2010) Identification of markers for newly formed beta-cells in the perinatal period: a time of recognized beta-cell immaturity. J Histochem Cytochem 58:369–376PubMedCrossRef
34.
Zurück zum Zitat Michael J, Carroll R, Swift HH, Steiner DF (1987) Studies on the molecular organization of rat insulin secretory granules. J Biol Chem 262:16531–16535PubMed Michael J, Carroll R, Swift HH, Steiner DF (1987) Studies on the molecular organization of rat insulin secretory granules. J Biol Chem 262:16531–16535PubMed
35.
Zurück zum Zitat Suckale J, Solimena M (2010) The insulin secretory granule as a signaling hub. Trends Endocrinol Metab 21:599–609PubMedCrossRef Suckale J, Solimena M (2010) The insulin secretory granule as a signaling hub. Trends Endocrinol Metab 21:599–609PubMedCrossRef
36.
Zurück zum Zitat MacDonald PE, Wheeler MB (2003) Voltage-dependent K(+) channels in pancreatic beta cells: role, regulation and potential as therapeutic targets. Diabetologia 46:1046–1062PubMedCrossRef MacDonald PE, Wheeler MB (2003) Voltage-dependent K(+) channels in pancreatic beta cells: role, regulation and potential as therapeutic targets. Diabetologia 46:1046–1062PubMedCrossRef
37.
Zurück zum Zitat De Vos A, Heimberg H, Quartier E et al (1995) Human and rat beta cells differ in glucose transporter but not in glucokinase gene expression. J Clin Invest 96:2489–2495PubMedCrossRef De Vos A, Heimberg H, Quartier E et al (1995) Human and rat beta cells differ in glucose transporter but not in glucokinase gene expression. J Clin Invest 96:2489–2495PubMedCrossRef
38.
Zurück zum Zitat Navarro-Tableros V, Fiordelisio T, Hernandez-Cruz A, Hiriart M (2007) Physiological development of insulin secretion, calcium channels, and GLUT2 expression of pancreatic rat beta-cells. Am J Physiol Endocrinol Metab 292:E1018–E1029PubMedCrossRef Navarro-Tableros V, Fiordelisio T, Hernandez-Cruz A, Hiriart M (2007) Physiological development of insulin secretion, calcium channels, and GLUT2 expression of pancreatic rat beta-cells. Am J Physiol Endocrinol Metab 292:E1018–E1029PubMedCrossRef
39.
Zurück zum Zitat Rozzo A, Meneghel-Rozzo T, Delakorda SL, Yang SB, Rupnik M (2009) Exocytosis of insulin: in vivo maturation of mouse endocrine pancreas. Ann N Y Acad Sci 1152:53–62PubMedCrossRef Rozzo A, Meneghel-Rozzo T, Delakorda SL, Yang SB, Rupnik M (2009) Exocytosis of insulin: in vivo maturation of mouse endocrine pancreas. Ann N Y Acad Sci 1152:53–62PubMedCrossRef
40.
Zurück zum Zitat Aguayo-Mazzucato C, Koh A, El Khattabi I et al (2011) Mafa expression enhances glucose-responsive insulin secretion in neonatal rat beta cells. Diabetologia 54:583–593PubMedCrossRef Aguayo-Mazzucato C, Koh A, El Khattabi I et al (2011) Mafa expression enhances glucose-responsive insulin secretion in neonatal rat beta cells. Diabetologia 54:583–593PubMedCrossRef
41.
Zurück zum Zitat Spigelman AF, Dai X, MacDonald PE (2010) Voltage-dependent K(+) channels are positive regulators of alpha cell action potential generation and glucagon secretion in mice and humans. Diabetologia 53:1917–1926PubMedCrossRef Spigelman AF, Dai X, MacDonald PE (2010) Voltage-dependent K(+) channels are positive regulators of alpha cell action potential generation and glucagon secretion in mice and humans. Diabetologia 53:1917–1926PubMedCrossRef
42.
Zurück zum Zitat MacDonald PE, Wang X, Xia F et al (2003) Antagonism of rat beta-cell voltage-dependent K+ currents by exendin 4 requires dual activation of the cAMP/protein kinase A and phosphatidylinositol 3-kinase signaling pathways. J Biol Chem 278:52446–52453PubMedCrossRef MacDonald PE, Wang X, Xia F et al (2003) Antagonism of rat beta-cell voltage-dependent K+ currents by exendin 4 requires dual activation of the cAMP/protein kinase A and phosphatidylinositol 3-kinase signaling pathways. J Biol Chem 278:52446–52453PubMedCrossRef
43.
Zurück zum Zitat Villasenor A, Chong DC, Cleaver O (2008) Biphasic Ngn3 expression in the developing pancreas. Dev Dyn 237:3270–3279PubMedCrossRef Villasenor A, Chong DC, Cleaver O (2008) Biphasic Ngn3 expression in the developing pancreas. Dev Dyn 237:3270–3279PubMedCrossRef
44.
Zurück zum Zitat Herrera PL, Nepote V, Delacour A (2002) Pancreatic cell lineage analyses in mice. Endocrine 19:267–278PubMedCrossRef Herrera PL, Nepote V, Delacour A (2002) Pancreatic cell lineage analyses in mice. Endocrine 19:267–278PubMedCrossRef
45.
Zurück zum Zitat Artner I, Blanchi B, Raum JC et al (2007) MafB is required for islet beta cell maturation. Proc Natl Acad Sci USA 104:3853–3858PubMedCrossRef Artner I, Blanchi B, Raum JC et al (2007) MafB is required for islet beta cell maturation. Proc Natl Acad Sci USA 104:3853–3858PubMedCrossRef
46.
Zurück zum Zitat Kelly OG, Chan MY, Martinson LA et al (2011) Cell-surface markers for the isolation of pancreatic cell types derived from human embryonic stem cells. Nat Biotechnol 29:750–756PubMedCrossRef Kelly OG, Chan MY, Martinson LA et al (2011) Cell-surface markers for the isolation of pancreatic cell types derived from human embryonic stem cells. Nat Biotechnol 29:750–756PubMedCrossRef
47.
Zurück zum Zitat Thorel F, Nepote V, Avril I et al (2010) Conversion of adult pancreatic alpha-cells to beta-cells after extreme beta-cell loss. Nature 464:1149–1154PubMedCrossRef Thorel F, Nepote V, Avril I et al (2010) Conversion of adult pancreatic alpha-cells to beta-cells after extreme beta-cell loss. Nature 464:1149–1154PubMedCrossRef
48.
Zurück zum Zitat Habener JF, Kemp DM, Thomas MK (2005) Minireview: transcriptional regulation in pancreatic development. Endocrinology 146:1025–1034PubMedCrossRef Habener JF, Kemp DM, Thomas MK (2005) Minireview: transcriptional regulation in pancreatic development. Endocrinology 146:1025–1034PubMedCrossRef
49.
Zurück zum Zitat Gefen-Halevi S, Rachmut IH, Molakandov K et al (2010) NKX6.1 promotes PDX-1-induced liver to pancreatic beta-cells reprogramming. Cell Reprogram 12:655–664PubMedCrossRef Gefen-Halevi S, Rachmut IH, Molakandov K et al (2010) NKX6.1 promotes PDX-1-induced liver to pancreatic beta-cells reprogramming. Cell Reprogram 12:655–664PubMedCrossRef
50.
Zurück zum Zitat Gauthier BR, Gosmain Y, Mamin A, Philippe J (2007) The beta-cell specific transcription factor Nkx6.1 inhibits glucagon gene transcription by interfering with Pax6. Biochem J 403:593–601PubMedCrossRef Gauthier BR, Gosmain Y, Mamin A, Philippe J (2007) The beta-cell specific transcription factor Nkx6.1 inhibits glucagon gene transcription by interfering with Pax6. Biochem J 403:593–601PubMedCrossRef
Metadaten
Titel
The functional and molecular characterisation of human embryonic stem cell-derived insulin-positive cells compared with adult pancreatic beta cells
verfasst von
C. L. Basford
K. J. Prentice
A. B. Hardy
F. Sarangi
S. J. Micallef
X. Li
Q. Guo
A. G. Elefanty
E. G. Stanley
G. Keller
E. M. Allister
M. C. Nostro
M. B. Wheeler
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
Diabetologia / Ausgabe 2/2012
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2335-x

Weitere Artikel der Ausgabe 2/2012

Diabetologia 2/2012 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.