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Pancreatic endoderm derived from human embryonic stem cells generates glucose-responsive insulin-secreting cells in vivo
Abstract
Development of a cell therapy for diabetes would be greatly aided by a renewable supply of human beta-cells. Here we show that pancreatic endoderm derived from human embryonic stem (hES) cells efficiently generates glucose-responsive endocrine cells after implantation into mice. Upon glucose stimulation of the implanted mice, human insulin and C-peptide are detected in sera at levels similar to those of mice transplanted with approximately 3,000 human islets. Moreover, the insulin-expressing cells generated after engraftment exhibit many properties of functional beta-cells, including expression of critical beta-cell transcription factors, appropriate processing of proinsulin and the presence of mature endocrine secretory granules. Finally, in a test of therapeutic potential, we demonstrate that implantation of hES cell-derived pancreatic endoderm protects against streptozotocin-induced hyperglycemia. Together, these data provide definitive evidence that hES cells are competent to generate glucose-responsive, insulin-secreting cells.
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“In particular, ViaCyte developed a stem cell-derived pancreatic endoderm cell population known as PEC-01, which they demonstrated to mature over several months in vivo into insulin-producing endocrine cells in rodent models.29–31”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [31]
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Successful Islet Transplantation
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Silva, F. D. S., Almeida, P. N., Rettore, J. V. P., Maranduba, C. P., de Souza, C. M., de Souza, G. T., Zanette, R. D. S. S., Miyagi, S. P. H., Santos, M. D. O., Marques, M. M., et al. (2012) · BioMed Research International · doi:10.1155/2012/758102 · Cited by 45
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“…and more recently microencapsulation of hESC-derived pancreatic progenitors differentiated into b cells could partially rescue streptozotocin (STZ)-induced hyperglycemia without triggering an immune response (Kroon et al., 2008; Lee et al., 2009; Robert et al., 2018; Vegas et al., 2016).”
BackgroundMethodResultInfluentialSelf-citationExamining How the MAFB Transcription Factor Affects Islet β-Cell Function Postnatally
Cyphert, H. A., Walker, E. M., Hang, Y., Dhawan, S., Haliyur, R., Bonatakis, L., Avrahami, D., Briššová, M., Kaestner, K. H., Bhushan, A., et al. (2018) · Diabetes · doi:10.2337/db18-0903 · Cited by 45
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“It has been shown that the combination use of growth factors by genetic manipulation enhanced the efficiency of MSCs (Kroon et al., 2008; Li et al., 2015).”
BackgroundClosing in on Mass Production of Mature Human Beta Cells.
Kieffer, T. (2016) · Cell Stem Cell · doi:10.1016/j.stem.2016.05.014 · Cited by 40
“NovoCell (now ViaCyte) was early to capitalize upon this knowledge, developing robust protocols for the step-wise differentiation of human ESCs through the stages of definitive endoderm, primitive gut tube, posterior foregut, and pancreatic endoderm (Kroon et al., 2008).”
BackgroundReplacing and safeguarding pancreatic β cells for diabetes
Bruin, J. E., Rezania, A., & Kieffer, T. J. (2015) · Science Translational Medicine · doi:10.1126/scitranslmed.aaa9359 · Cited by 45
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Mastracci, T. L., Robertson, M. A., Mirmira, R. G., & Anderson, R. M. (2015) · Scientific Reports · doi:10.1038/srep13269 · Cited by 38
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“A two-step procedure to differentiate hESCs into mature insulin b cells in vivo has been described [76].”
MethodStem cells to insulin secreting cells: two steps forward and now a time to pause?
Kushner, J., Macdonald, P., & Atkinson, M. (2014) · Cell Stem Cell · doi:10.1016/j.stem.2014.10.012 · Cited by 39
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BackgroundKallas, A., Pook, M., Trei, A., & Maimets, T. (2014) · Stem Cells International · doi:10.1155/2014/298163 · Cited by 39
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“Furthermore, the implanted cells were able to protect against streptozotocin induced diabetes (125).”
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“This effectively promoted cell maturation in vivo [41].”
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“…Ostrom et al., 2008; Penny and Kramer, 2000; Stafford et al., 2004, 2006; Stafford and Prince, 2002; Tulachan et al., 2003) and in hESC in vitro differentiation (D’Amour et al., 2006; Jiang et al., 2007; Johannesson et al., 2009; Kroon et al., 2008; Rezania et al., 2012, 2013; Zhang et al., 2009).”
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“Most importantly, non-differentiated escapees may produce teratomas upon transplantation (Kroon et al., 2008).”
BackgroundCurrent status and future of clinical islet xenotransplantation
Matsumoto, S., Tomiya, M., & Sawamoto, O. (2016) · Journal of Diabetes · doi:10.1111/1753-0407.12395 · Cited by 38
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“Kroon et al [11] reported that transplantation of hESC-derived pancreatic endodermal cells into SCID/NOD mice gave rise to glucose-sensitive insulin-secreting cells and were capable of correcting hyperglycemia, suggesting that exposure to high glucose levels in vivo could enhance the maturation of pancreatic precursor…”
BackgroundMethodInfluentialChemical approaches to studying stem cell biology
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BackgroundPancreas-on-a-Chip Technology for Transplantation Applications
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“These differentiated cells display architectural similarity to mature primary islets, are capable of synthesizing insulin, glucagon, somatostatin, pancreatic polypeptide and ghrelin [229, 230], reverse hyperglycemia in diabetic mice, prolong graft survival, and respond successfully to glucose challenge in glucose-tole…”
BackgroundZhang, Y.-H., Shen, W.-Z., Hua, J., Lei, A.-M., Lv, C., Wang, H.-Y., Yang, C.-R., Gao, Z.-M., & Dou, Z. (2010) · Rejuvenation Research · doi:10.1089/rej.2009.1016 · Cited by 36
Cyp26 enzymes function in endoderm to regulate pancreatic field size
Kinkel, M. D., Sefton, E. M., Kikuchi, Y., Mizoguchi, T., Ward, A. B., & Prince, V. (2009) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0813108106 · Cited by 39
Emamaullee, J. A., Pepper, A. R., & Shapiro, A. M. J. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-809880-6.00056-4 · Cited by 12
Determinants and dynamics of pancreatic islet architecture
Adams, M. T., & Blum, B. (2022) · Islets · doi:10.1080/19382014.2022.2030649 · Cited by 44
From Genetic Association to Molecular Mechanisms for Islet-cell Dysfunction in Type 2 Diabetes
Mattis, K. K., & Gloyn, A. L. (2020) · Journal of Molecular Biology · doi:10.1016/j.jmb.2019.12.045 · Cited by 39
Single‐cell transcriptomic analyses reveal distinct dorsal/ventral pancreatic programs
Li, L.-C., Qiu, W.-L., Zhang, Y.-W., Xu, Z.-R., Xiao, Y.-N., Hou, C., Lamaoqiezhong, Yu, P., Cheng, X., & Xu, C.-R. (2018) · EMBO Reports · doi:10.15252/embr.201846148 · Cited by 35
Extracellular NME proteins: a player or a bystander?
Romani, P., Ignesti, M., Gargiulo, G., Hsu, T., & Cavaliere, V. (2018) · Laboratory Investigation · doi:10.1038/labinvest.2017.102 · Cited by 35
Gabr, M. M., Zakaria, M. M., Refaie, A. F., Khater, S. M., Ashamallah, S. A., Ismail, A. M., El-Halawani, S. M., & Ghoneim, M. A. (2015) · BioMed Research International · doi:10.1155/2015/575837 · Cited by 35
Efthymiou, A. G., Chen, G., Rao, M. S., Chen, G., & Boehm, M. (2014) · Expert Opinion on Biological Therapy · doi:10.1517/14712598.2014.922533 · Cited by 39
“7 Insulin producing cells (b cells) Several studies have reported the generation of DE or foregut endoderm, pancreatic progenitors or insulin producing cells (b cells) from hPSCs in vitro [79,80].”
BackgroundCechin, S., Álvarez-Cubela, S., Giraldo, J. A., Molano, R., Villate, S., Ricordi, C., Pileggi, A., Inverardi, L., Fraker, C., & Domínguez-Bendala, J. (2014) · Stem Cells Translational Medicine · doi:10.5966/sctm.2013-0160 · Cited by 35
Essential role of clusterin in pancreas regeneration
Lee, S., Hong, S., Min, B., Shim, Y.-J., Lee, K., Lee, I., Bendayan, M., Aronow, B. J., & Park, I.-S. (2011) · Developmental Dynamics · doi:10.1002/dvdy.22556 · Cited by 33
“…vitro differentiation of beta-cell phenotypes from embryonic and adult pancreatic stem cells and its potential to be used in islet transplantation (Kroon et al., 2008; Serafimidis et al., 2008), there remains a need to under- stand critical genes and pathways required for the expansion and…”
BackgroundStem cell approaches for the treatment of type 1 diabetes mellitus
Wagner, R. T., Lewis, J., Cooney, A. J., & Chan, L. (2010) · Translational research · doi:10.1016/j.trsl.2010.06.005 · Cited by 33
“…neuronal progenitors.98 Two pivotal studies that describe the differentiation of ESCs to pancreatic endoderm reported in (D'Amour et al. 2006;93 and Kroon et al. 2008;99 and highlighted below) sought to recapitulate four stages of embryonic development in order to obtain glucose responsive…”
BackgroundNaujok, O., Kaldrack, J., Taivankhuu, T., Jörns, A., & Lenzen, S. (2010) · Stem Cell Reviews and Reports · doi:10.1007/s12015-010-9148-z · Cited by 35
“Although sophisticated differentiation protocols may decrease the risk of tumor formation, they may not preclude a long-life risk of tumor onset [ 4 ].”
BackgroundHuman parthenogenetic embryonic stem cells: one potential resource for cell therapy
Hao, J., Zhu, W.-W., Sheng, C., Yu, Y., & Zhou, Q. (2009) · Science in China Series C Life Sciences · doi:10.1007/s11427-009-0096-2 · Cited by 35
Pdx1 regulates pancreas tubulogenesis and E-cadherin expression
Marty‐Santos, L., & Cleaver, O. B. (2015) · Development · doi:10.1242/dev.126755 · Cited by 41
“Progress has been made in driving embryonic stem cells or other pancreatic cell types towards β-cell fate in culture (D’Amour et al., 2005; Kroon et al., 2008; Pagliuca et al., 2014; Rezania et al., 2014; Zhou et al., 2008); however, this remains an inefficient and poorly understood process.”
BackgroundIn vitro differentiation of human amniotic epithelial cells into insulin-producing 3D spheroids
Okere, B., Alviano, F., Costa, R., Quaglino, D., Ricci, F., Dominici, M., Paolucci, P., Bonsi, L., & Iughetti, L. (2015) · International Journal of Immunopathology and Pharmacology · doi:10.1177/0394632015588439 · Cited by 34
Pezzolla, D., López‐Beas, J., Lachaud, C. C., Domínguez‐Rodríguez, A., Smani, T., Hmadcha, A., & Soria, B. (2015) · PLoS ONE · doi:10.1371/journal.pone.0119904 · Cited by 33
“As a consequence, many research groups omitted the late in vitro differentiation steps, and allowed pancreatic progenitors to specialize into functional β-cell by in vivomaturation after transplantation in STZ-induced hyperglycaemic mice [12,14–16,54] or included small molecules and growth factors to medium formulatio…”
Overcoming barriers in clinical islet transplantation: Current limitations and future prospects
Chhabra, P., Sutherland, D. E. R., & Brayman, K. L. (2013) · Current Problems in Surgery · doi:10.1067/j.cpsurg.2013.10.002 · Cited by 40
Pancreatic Islet Cell Transplantation: An Update
Hatziavramidis, D., Karatzas, T., & Chrousos, G. P. (2012) · Annals of Biomedical Engineering · doi:10.1007/s10439-012-0676-3 · Cited by 31
Epigenetic regulation of pancreas development and function
Avrahami, D., & Kaestner, K. H. (2012) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2012.06.002 · Cited by 33
“Only when transplanted into mice for an ‘in vivo maturation’ period of about five month, these human ES-derived, β-like cells are capable of maintaining normal blood glucose levels [58].”
BackgroundGenerating Cells from Stem Cells--The Story So FarPreprint
Hebrok, M. (2012) · Cold Spring Harbor Perspectives in Medicine · doi:10.1101/cshperspect.a007674 · Cited by 41
Generation of pancreatic islet cells from human embryonic stem cells
Zhang, D.-H., Jiang, W., Shi, Y., & Deng, H. (2009) · Science in China Series C Life Sciences · doi:10.1007/s11427-009-0095-3 · Cited by 34
Insulin producing cells derived from embryonic stem cells: Are we there yet?
Raikwar, S. P., & Zavazava, N. (2008) · Journal of Cellular Physiology · doi:10.1002/jcp.21615 · Cited by 31
Recent Advances in Cell Replacement Therapies for the Treatment of Type 1 Diabetes
Cogger, K. F., & Nostro, M. C. (2014) · Endocrinology · doi:10.1210/en.2014-1691 · Cited by 37
“These results are in agreement with previous data reporting the generation of -like cells after transplantation of a heterogeneous population of hESC-derived pancreatic cells (56, 61) and confirm that human polyhormonal cells generated in vitro do not give rise to functional -cells in vivo, similarly to the polyhormon…”
Small Molecules in Cellular Reprogramming and Differentiation
Xu, Y., Li, W., & Ding, S. (2010) · Springer eBooks · doi:10.1007/978-3-7643-8989-5_13 · Cited by 34
“... mesendoderm and definitive endoderm mainly by Activin A and Wnt treatment of ES cells, followed by a series of cytokine and small molecule treatments, including FGF10, Hedgehog antagonists (i.e., cyclopamine), retinoic acids, Notch inhibitors (i.e., DAPT), nicotinamide, directing cells through stages resembling po…”
BackgroundRojas, A., Khoo, A., Tejedo, J. R., Bedoya, F. J., Soria, B., & Martı́n, F. (2010) · Advances in experimental medicine and biology · doi:10.1007/978-90-481-3271-3_4 · Cited by 29
“Although success in generating insulin-producing cells from stem cells has been highly variable and even controversial, recent reports show promising results in the derivation of endoderm cells from embryonic stem cells and subsequent in vitro or in vivo differentiation into insulin-producing cells [14, 15, 34, 35, 44…”
ResultUnderstanding stem cells and its pivotal role in regenerative medicine
Sarkar, A., Saha, S., Paul, A., Maji, A., Roy, P., & Maity, T. K. (2021) · Life Sciences · doi:10.1016/j.lfs.2021.119270 · Cited by 47
Liu, W., Ren, Z.-L., Lu, K., Song, C.-C., Cheung, E., Zhou, Z., & Chen, G.-K. (2018) · International Journal on Biological Sciences · doi:10.7150/ijbs.24681 · Cited by 33
“Furthermore, many differentiation procedures are conducted at confluent density to generate cardiac[14-16], hepatic[17], pancreatic[18, 19] and neural lineage cells[20].”
BackgroundCombining Induced Pluripotent Stem Cells and Genome Editing Technologies for Clinical Applications
Chang, C.-Y., Ting, H.-C., Su, H., & Jeng, J. (2018) · Cell Transplantation · doi:10.1177/0963689718754560 · Cited by 39
Hossain, M. K., Dayem, A. A., Han, J., Saha, S. K., Yang, G., Choi, H. Y., & Cho, S. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17020256 · Cited by 53
“Treatment with several small molecules, such as forskolin and dexamethasone [45], IGF-1 (insulin like growth factor 1), HGF (hepatocyte growth factor), and GLP-1, has been used to enhance insulin-secreting pancreatic β cells maturation in vitro [70].”
BackgroundKatz, L. S., Geras‐Raaka, E., & Gershengorn, M. C. (2013) · Stem Cells and Development · doi:10.1089/scd.2013.0134 · Cited by 35
Chun, S. Y., Mack, D. L., Moorefield, E., Oh, S. H., Kwon, T. G., Pettenati, M. J., Yoo, J. J., Coppi, P. D., Atala, A., & Söker, S. (2012) · Journal of Tissue Engineering and Regenerative Medicine · doi:10.1002/term.1631 · Cited by 29
Tissue engineering 2.0: guiding self-organization during pluripotent stem cell differentiation
Woodford, C. M., & Zandstra, P. W. (2012) · Current Opinion in Biotechnology · doi:10.1016/j.copbio.2012.03.003 · Cited by 34
“Competency for glucose-stimulated insulin secretion is developed by hPSC-derived pancreatic progenitors that mature in vivo over approximately 3 months [61].”
iPS Cells in Type 1 Diabetes Research and Treatment
Maehr, R. (2011) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2011.1 · Cited by 28
Phosphorylation within the MafA N Terminus Regulates C-terminal Dimerization and DNA Binding*
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“In a subsequent study, Kroon et al. [11] evolved the protocol to differentiate hESCs, utilizing fibroblast growth factors (FGFs) and bone morphogenetic proteins (BMPs) to establish pancreatic progenitors.”
Encapsulated islet transplantation
Liu, S. S., Shim, S., Kudo, Y., Stabler, C. L., O’Cearbhaill, E. D., Karp, J. M., & Yang, K. (2024) · Nature Reviews Bioengineering · doi:10.1038/s44222-024-00238-6 · Cited by 42
“8,9,17,18,39,48,52,59,64–67,69,76,83,115,156,196,197.”
Macroencapsulation Devices for Cell Therapy
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Metadata
- Authors
- Kroon, E., Martinson, L. A., Kadoya, K., Bang, A. G., Kelly, O. G., Eliazer, S., Young, H., Richardson, M., Smart, N. G., Cunningham, J., Agulnick, A. D., D'Amour, K. A., Carpenter, M. K., & Baetge, E. E.
- Venue
- Nature Biotechnology
- Published
- 2008-02-20
- Volume
- 26
- Issue
- 4
- Pages
- 443-452
- ISSN
- 0733-222X (ISSN-L)
- 1087-0156
- 1546-1696
- OpenAlex
- W2106219965
- Cited by
- 1,843
- References
- 0
- Citations by year
- 2026: 26 · 2025: 44 · 2024: 46 · 2023: 88 · 2022: 67 · 2021: 81 · 2020: 85 · 2019: 76 · 2018: 87 · 2017: 98 · 2016: 122 · 2015: 116 · 2014: 156 · 2013: 168 · 2012: 154
- FWCI
- 150.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Biotechnology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Pluripotent Stem Cells Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- human embryonic stem cells, beta cell differentiation, glucose-dependent insulin secretion, islet transplantation, diabetes cell therapy, C-peptide, proinsulin processing, streptozotocin-induced hyperglycemia
- MeSH terms
- Animals, Cell Differentiation, Cells, Cultured, Endoderm, Glucose, Humans, Insulin, Cell Culture Techniques, Pancreas, Artificial, Tissue Engineering, Cell Proliferation, Insulin-Secreting Cells, Mice, Embryonic Stem Cells
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