Beta-cell replacement for type 1 diabetes: integrating cell products, engraftment and immune protection.
- 1The Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
- 2Zhejiang Chinese Medical University, Hangzhou, China.
- 3The First Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
Abstract
Beta-cell replacement aims to restore endogenous, glucose-responsive insulin secretion in type 1 diabetes. Donor-islet transplantation has shown that this approach can improve glycaemic control and prevent severe hypoglycaemia. Its wider use is limited by donor supply, early graft loss and chronic systemic immunosuppression. Pluripotent stem cells provide a renewable source of pancreatic progenitors and differentiated islet products. Recent clinical studies have reported C-peptide secretion and insulin independence in some recipients. However, cell supply is only one part of the problem. Product maturity, graft composition, implantation site, vascular support, immune injury and manufacturing quality all affect outcome. This review examines these factors as parts of one treatment system. It compares donor islets, stem-cell-derived products and islet-like organoids, then evaluates delivery and immune-protection strategies. It also considers clinical endpoints, patient selection and safety. We define functional cure as durable endogenous insulin secretion with physiological benefit at an acceptable total treatment burden. Current evidence provides early evidence of clinical activity and, in selected recipients, clinically meaningful efficacy. However, the available studies involve highly selected participants, small cohorts and/or systemic immunosuppression. No platform has yet combined durable function, immune control, scalable production and acceptable long-term safety.
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BibTeX
@article{chen2026betacell,
title = {{Beta-cell replacement for type 1 diabetes: integrating cell products, engraftment and immune protection.}},
author = {Lan Chen and Xinhao Hu and Chen Zheng and Qi Huang and Jiani Xu and Xiongbin You and Chenfang Wang},
journal = {Frontiers in endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1981945},
url = {https://europepmc.org/article/MED/42898925},
note = {CC BY},
}
RIS
TY - JOUR
TI - Beta-cell replacement for type 1 diabetes: integrating cell products, engraftment and immune protection.
AU - Lan Chen
AU - Xinhao Hu
AU - Chen Zheng
AU - Qi Huang
AU - Jiani Xu
AU - Xiongbin You
AU - Chenfang Wang
PY - 2026
DA - 2026/10/05
JO - Frontiers in endocrinology
DO - 10.3389/fendo.2026.1981945
UR - https://europepmc.org/article/MED/42898925
AB - Beta-cell replacement aims to restore endogenous, glucose-responsive insulin secretion in type 1 diabetes. Donor-islet transplantation has shown that this approach can improve glycaemic control and prevent severe hypoglycaemia. Its wider use is limited by donor supply, early graft loss and chronic systemic immunosuppression. Pluripotent stem cells provide a renewable source of pancreatic progenitors and differentiated islet products. Recent clinical studies have reported C-peptide secretion and insulin independence in some recipients. However, cell supply is only one part of the problem. Product maturity, graft composition, implantation site, vascular support, immune injury and manufacturing quality all affect outcome. This review examines these factors as parts of one treatment system. It compares donor islets, stem-cell-derived products and islet-like organoids, then evaluates delivery and immune-protection strategies. It also considers clinical endpoints, patient selection and safety. We define functional cure as durable endogenous insulin secretion with physiological benefit at an acceptable total treatment burden. Current evidence provides early evidence of clinical activity and, in selected recipients, clinically meaningful efficacy. However, the available studies involve highly selected participants, small cohorts and/or systemic immunosuppression. No platform has yet combined durable function, immune control, scalable production and acceptable long-term safety.
SN - 1664-2392
ER -