Bone marrow-derived cells and the vasculature in diabetes: from biomarker to treatment?

Excerpt

In early June 2007, a search for ‘stem cells’ and ‘diabetes’ in PubMed retrieved 549 articles. The breakdown was rather skewed: 497 were published after the year 2000, whilst a mere 52 were published earlier. This difference largely reflects the first description of human embryonic stem cells (ESCs) in 1998 [1]. Nearly a decade has passed since then, and stem cell research has diversified. Human ESCs for engineering transplantable beta cells ex vivo have attracted great interest in both the commercial and academic sectors, but have yet to deliver in the clinic—a timeline of which we should perhaps be proud, given the need for ESC-derived therapy to be as least as safe and effective as exogenous insulin therapy. However, pluripotency, the ability of a precursor to turn into many different cell types, has undoubtedly raised public, government and academic awareness of a much broader area of research. Clinicians may feel some cynicism at the thought of transplanting beta cells produced ex vivo from ESCs to achieve injection-free, safe, curative therapy, but the concept of regenerative medicine—growing back missing cells, organs and tissues by reawakening differentiation from endogenous precursors—has been taken up with renewed optimism [2, 3]. Whatever one’s opinion, the research and the debate have proved exciting, and a significant proportion has been played out in Diabetologia [4‐11]. …