beta-Cell Replacement Strategies: The Increasing Need for a “beta-Cell Dogma”.
Type 1 diabetes is an auto-immune disease resulting in the loss of pancreatic beta-cells and,
consequently, in chronic hyperglycemia. Insulin supplementation allows diabetic patients to control
their glycaemia quite efficiently, but treated patients still display an overall shortened life
expectancy and an altered quality of life as compared to their healthy counterparts. In this context
and due to the ever increasing number of diabetics, establishing alternative therapies has become a
crucial research goal. Most current efforts therefore aim at generating fully functional
insulin-secreting beta-like cells using multiple approaches. In this review, we screened the
literature published since 2011 and inventoried the selected markers used to characterize
insulin-secreting cells generated by in vitro differentiation of stem/precursor cells or by means of
in vivo transdifferentiation. By listing these features, we noted important discrepancies when
comparing the different approaches for the initial characterization of insulin-producing cells as
true beta-cells. Considering the recent advances achieved in this field of research, the necessity
to establish strict guidelines has become a subject of crucial importance, especially should one
contemplate the next step, which is the transplantation of in vitro or ex vivo generated
insulin-secreting cells in type 1 diabetic patients.