Tratamento do diabetes mellitus do tipo 1 com células tronco
DOI:
https://doi.org/10.33233/nb.v15i3.214Resumo
Diabetes mellitus (DM) é uma doença crônica caracterizada pela alta taxa de glicose no sangue e que, a longo prazo, pode ocasionar complicações e sérios danos ao coração, vasos sanguíneos, olhos, rins e nervos. A incidência de indivíduos portadores de diabetes tem aumentado no mundo todo. O diabete pode ser classificado em três diferentes categorias: DM tipo 1, DM tipo 2 e DM gestacional. O atual avanço no conhecimento e utilização das células-tronco tem se mostrado eficaz e promissor no tratamento de algumas doenças, em especial do DM1. O tratamento empregado para o DM1 é a administração de insulina, que controla a glicemia dos pacientes. No entanto, o tratamento com insulina não leva í restauração das células beta-pancreáticas e não evita o aparecimento de complicações secundárias de forma definitiva. O transplante de ilhotas pancreáticas como alternativa tem como limitação o uso de terapia imunossupressora, a rejeição imune e a falta de doadores do órgão. Dessa forma essa atualização relata estudos que proporcionam o desenvolvimento de células beta pancreáticas, responsáveis pela síntese e secreção de insulina, a partir de células-tronco para tratamento do DM1.
Palavras-chave: diabetes, células-tronco embrionárias, hiperglicemia, pâncreas.Â
Referências
World Health Organization (WHO) [Internet]. The Organization; 2015 [update 2014; cited 2015 Oct 26]. 10 facts about diabetes; [about 1p]. Available from: http://www.who.int/features/factfiles/diabetes/en/.
World Health Organization (WHO) [Internet]. The Organization; 2015 [update 2015; cited 2015 Oct 26]. Media Center - Diabetes; [about 1p]. Available from: http://www.who.int/mediacentre/factsheets/fs312/en/
Portal Brasil [Internet]. Portal; 2015 [update 2015; cited 2016 Nov 10]. Diabetes atinge 9 milhões de brasileiros; [about 1p]. Available from: http://www.brasil.gov.br/saude/2015/07/diabetes-atinge-9-milhoes-de-brasileiros
World Health Organization (WHO) [Internet]. The Organization; 2015 [update 2014; cited 2015 Oct 28]. Diabetes Programmer; [about 1p]. Available from: http://www.who.int/diabetes/en/
American Diabetes Association (ADA). Classification and Diagnosis of Diabetes. Diabetes Care 2015;38(Suppl1):S1,S8,S10,S11.
Mayhew CN, Wells JM. Converting human pluripotent stem cells into beta-cells: recent advances and future challenges. Curr Opin Organ Transplant 2010;15(1):54-60.
Balda CA, Pacheco-Silva A. Immunologic aspects of type 1 diabetes mellitus. Rev Assoc Med Bras 1999;45(2):175-80.
Sociedade Brasileira de Endocrinologia e Metabologia (SBEM). Sociedade [Internet]. 2006 [update 2006; cited 2015 Oct 28]. Diabetes Mellitos Gestacional. Available from: http://www.projetodiretrizes.org.br/5_volume/14-Diabet.pdf
World Health Organization (WHO) [Internet]. The Organization; 2015 [update 2013; cited 2015 Nov 05]. Diabetes Gestacional; [about 1p]. Available from: http://www.diabetes.org.br/ultimas/diabetes-gestacional
Weinert LS, Silveiro SP, Oppermann ML, Salazar CC, Simionato BM, Siebeneichler A et al. Diabetes gestacional: um algoritmo de tratamento multidisciplinar. Arq Bras Endocrinol Metabol 2011;55(7):435-45.
Efrat S. Generation of insulin-producing cells from stem cells for cell replacement therapy of type 1 diabetes. Isr Med Assoc J 2004 May;6(5):265-7.
Weems P, Cooper M. Pancreas transplantation in type II diabetes mellitus. World J Transplant. 2014;4(4):216-21.
Shapiro AM, Ricordi C, Hering BJ, Auchincloss H, Lindblad R, Robertson RP et al. International trial of the Edmonton protocol for islet transplantation. N Engl J Med 2006;355(13):1318-30.
Shao S, Gao Y, Xie B, Xie F, Lim SK, Li G. Correction of hyperglycemia in type 1 diabetic models by transplantation of encapsulated insulin-producing cells derived from mouse embryo progenitor. J Endocrinol 2011;208(3):245-55.
Kelly C, Flatt CC, McClenaghan NH. Stem cell-based approaches for the treatment of diabetes. Stem Cells Int 2011;2011:424986.
Newby BN, Terada N, Mathews CE. In search of a surrogate: engineering human beta cell lines for therapy. Trends Endocrinol Metab 2014;25(8):378-80.
Agulnick AD, Ambruzs DM, Moorman MA, Bhoumik A, Cesario RM, Payne JK et al. Insulin-producing endocrine cells differentiated in vitro from human embryonic stem cells function in macroencapsulation devices in vivo. Stem Cells Transl Med 2015;4(10):1214-22.
Schulz TC. Concise Review: Manufacturing of Pancreatic Endoderm Cells for Clinical Trials in Type 1 Diabetes. Stem Cells Transl Med 2015;4(8):927-31.
Evans-Molina C, Vestermark GL, Mirmira RG. Development of Insulin Producing Cells From Primitive Biologic Precursors. Curr Opin Organ Transplant 2009;14(1):56-63.
Korytnikov R, Nostro MC. Generation of polyhormonal and multipotent pancreatic progenitor lineages from human pluripotent stem cells. Methods. 2015 pii:S1046-2023(15):30135-3.
Schulz TC, Young HY, Agulnick AD, Babin MJ, Baetge EE, Bang AG et al. A scalable system for production of functional pancreatic progenitors from human embryonic stem cells. PLoS One 2012;7(5):e37004.
Calafiore R, Montanucci P, Basta G. Stem cells for pancreatic β-cell replacement in diabetes mellitus: actual perspectives. Curr Opin Organ Transplant. 2014;19(2):162-8.
Grinfeld S, Gomes RGC. Células-tronco: um breve estudo. International Jornal of Dentistry 2004;3(1):324-9.
Rippon HJ and Bishop AE. Embryonic stem cells. Cell Prolif. 2004; 37, 23–34.
Biwas and Hucthins. Embryonic Stem Cells. Stem Cells and development 2007;16:213–21.
Capasso D and E Brown et al. Genetic Science Learning Centre, University of Utah. DisponÃvel em URL: http://gslc.genetics.utah.edu/units/stem cells/whatissc/; 2007.
Instituto de Pesquisa com células-tronco (IPCT) [Internet]. Instituto; 2013. [update 2013; cited 2015 Nov 09]. Células-tronco; [about 1p]. Available from: http://celulastroncors.org.br/celulas-tronco-2/
Richardson T, Kumta PN, Banerjee I. Alginate encapsulation of human embryonic stem cells to enhance directed differentiation to pancreatic islet-like cells. Tissue Eng Part A. 2014; 20(23-24): 3198-211.
Bose B, Shenoy SP, Konda S, Wangikar P. Human embryonic stem cell differentiation into insulin secreting β-cells for diabetes. Cell Biol Int 2012;36(11):1013-20.
Banerjee I, Sharma N, Yarmush M. Impact of co-culture on pancreatic differentiation of embryonic stem cells. J Tissue Eng Regen Med 2011;5(4):313-23.
Rezania A, Bruin JE, Riedel MJ, Mojibian M, Asadi A, Xu J et al. Maturation of human embryonic stem cell-derived pancreatic progenitors into functional islets capable of treating pre-existing diabetes in mice. Diabetes 2012;61(8):2016-29.
Vija L, Farge D, Gautier JF, Vexiau P, Dumitrache C, Bourgarit A et al. Mesenchymal stem cells: Stem cell therapy perspectives for type 1 diabetes. Diabetes Metab 2009;35(2):85-93.
Wu H, Mahato R. Mesenchymal stem cell-based therapy for type 1 diabetes. Discov Med 2014;17(93):139-43.
http://biomed.brown.edu/Courses/BI108/BI108_2002_Groups/pancstems/stemcell/adultvsembryonicsc.htm
Schiesser JV, Micallef SJ, Hawes S, Elefanty AG, Stanley EG. Derivation of insulin-producing beta-cells from human pluripotent stem cells. Rev Diabet Stud 2014;11(1):6-18.
Wen Y, Chen B, Ildstad ST. Stem cell-based strategies for the treatment of type 1 diabetes mellitus. Expert Opin Biol Ther 2011;11(1):41-53.
Sui J, Mehta M, Shi B, Morahan G, Jiang FX. Directed differentiation of embryonic stem cells allows exploration of novel transcription factor genes for pancreas development. Stem Cell Rev 2012;8(3):803-12.
Roche E, Vicente-Salar N, Arribas M, Paredes B. Cell differentiation: therapeutical challenges in diabetes. J Stem Cells 2012;7(4):211-28.
Lee DH, Chung HM. Differentiation into endoderm lineage: pancreatic differentiation from embryonic stem cells. Int J Stem Cells 2011;4(1):35-42.
Schiesser JV, Wells JM. Generation of β cells from human pluripotent stem cells: are we there yet? Ann N Y Acad Sci 2014;1311:124-37.
Moore SJ, Gala-Lopez BL, Pepper AR, Pawlick RL, Shapiro AJ. Bioengineered stem cells as an alternative for islet cell transplantation. World J Transplant 2015;5(1):1-10.
Tuch BE, Hughes TC, Evans MD. Encapsulated pancreatic progenitors derived from human embryonic stem cells as a therapy for insulin-dependent diabetes. Diabetes Metab Res Rev 2011;27(8):928-32.
Raikwar SP, Zavazava N. PDX1-engineered embryonic stem cell-derived insulin producing cells regulate hyperglycemia in diabetic mice. Transplant Res 2012;1(1):19.
Vogel G. Biomedicine. Stem Cells recipe offers diabetes hope. Science 2014; 346(6206):148.
Candiello J, Singh SS, Task K, Kumta PN, Banerjee I. Early differentiation patterning of mouse embryonic stem cells in response to variations in alginate substrate stiffness. J Biol Eng 2013;7(1):9.
Muir KR, Lima MJ, Docherty HM, Docherty K. Cell therapy for type 1 diabetes. QJM 2014;107(4):253-9.
O'Sullivan ES, Vegas A, Anderson DG, Weir GC. Islets transplanted in immunoisolation devices: a review of the progress and the challenges that remain. Endocr Rev 2011;32(6):827-44.
Motté E, Szepessy E, Suenens K, Stangé G, Bomans M, Jacobs-Tulleneers-Thevissen D et al. Composition and function of macroencapsulated human embryonic stem cell-derived implants: comparison with clinical human islet cell grafts. J Physiol Endocrinol Metab 2014;307(9):E838-46.
Cechin S, Alvarez-Cubela S, Giraldo JA, Molano RD, Villate S, Ricordi C et al. Influence of in vitro and in vivo oxygen modulation on β cell differentiation from human embryonic stem cells. Stem Cells Transl Med 2014;3(3):277-89.
Guo T, Landsman L, Li N, Hebrok M. Factors expressed by murine embryonic pancreatic mesenchyme enhance generation of insulin-producing cells from hESCs. Diabetes 2013;62(5):1581-92.
Zavazava N. Progress toward establishing embryonic stem or induced pluripotent stem cell-based clinical translation. Curr Opin Organ Transplant 2014;19(6):598-602.
Chhabra P, Brayman KL. Stem cell therapy to cure type 1 diabetes: from hype to hope. Stem Cells Transl Med 2013;2(5):328-36.
Bruns H, Schultze D, Schemmer P. Alternatives to islet transplantation: future cell sources of beta-like cells. Clin Transplant 2013;27(Suppl25):30-3.
Godfrey KJ, Mathew B, Bulman JC, Shah O, Clement S, Gallicano GI. Stem cell-based treatments for Type 1 diabetes mellitus: bone marrow, embryonic, hepatic, pancreatic and induced pluripotent stem cells. Diabet Med 2012;29(1):14-23.
Voltarelli JC, Couri CE, Rodrigues MC, Moraes DA, Stracieri AB, Pieroni F et al. Stem cell therapies for type 1 diabetes mellitus. Indian J Exp Biol 2011;49(6):395-400.
Jeon K, Lim H, Kim JH, Thuan NV, Park SH, Lim YM et al. Differentiation and transplantation of functional pancreatic beta cells generated from induced pluripotent stem cells derived from a type 1 diabetes mouse model. Stem Cells Dev 2012;21(14):2642-55.
DomÃnguez-Bendala J, Inverardi L, Ricordi C. Stem cell-derived islet cells for transplantation. Curr Opin Organ Transplant 2011;16(1):76-82.
