Published online Jul 26, 2025. doi: 10.4252/wjsc.v17.i7.104607
Revised: March 26, 2025
Accepted: June 18, 2025
Published online: July 26, 2025
Processing time: 210 Days and 0.3 Hours
Type 1 diabetes (T1D) results from the autoimmune-mediated loss of pancreatic β-cells. Current insulin therapies offer symptomatic relief but fall short of providing a definitive cure. Islet cell transplantation, while promising, faces limitations related to donor scarcity, procedural complexities, and the necessity for long-term immunosuppression. Consequently, there is an urgent need for innovative strategies aimed at β-cell regeneration. Patient-derived induced pluripotent stem cells (iPSCs), obtained from peripheral blood mononuclear cells (PBMCs) of T1D patients, hold great potential as a source of cells for therapeutic purposes. Therefore, the differentiation of T1D-iPSCs into functional pancreatic β-cells is a critical step toward effective β-cell replacement therapy.
To assess the potential of patient-derived T1D-β-like cells (differentiated from T1D-iPSCs reprogrammed from T1D-PBMCs) for restoring β-cell function in T1D.
T1D-iPSCs were reprogrammed from T1D-PBMCs using an episomal vector-based approach. Pluripotency was confirmed by flow cytometry (FCM), quanti
T1D-iPSCs were successfully generated from T1D-PBMCs. These cells exhibited the hallmark characteristics of pluripotent stem cells, including appropriate morphology, differentiation potential, genomic integrity, and expression of pluripotency-associated genes. Differentiation yielded insulin-positive (insulin+) pancreatic β-like cells that, at the mRNA level, expressed key β-cell markers such as pancreatic duodenal homeobox-1, Ngn3, MafA, NeuroD, glucagon-like peptide-1 receptor, Nkx6.1, glucose transporter 2, and Kir6.2. Notably, the T3 + Vc group displayed the lowest Ngn3 expression (1.31 ± 0.38 vs 1.96 ± 0.25 vs 2.51 ± 0.24, P < 0.01), while the M3C + T3 + Vc group exhibited the highest MafA expression (0.49 ± 0.11 vs 0.32 ± 0.06 vs 0.29 ± 0.08, P < 0.05). Both in vitro and in vivo assessments confirmed the insulin secretion ability of the generated β-like cells; however, they did not demonstrate appropriate modulation of insulin release in response to variations in extracellular glucose concentrations.
T1D-iPSCs derived from T1D-PBMCs can be differentiated into insulin+ β-like cells, albeit with functional immaturity. These cells represent a potential source of seed cells for β-cell replacement therapy in T1D.
Core Tip: This study successfully employed an episomal plasmid system to reprogram patient peripheral blood mononuclear cells into type 1 diabetes (T1D)-induced pluripotent stem cells (iPSCs). Optimization of the differentiation protocol, utilizing triiodothyronine (T3), vitamin C (Vc), and adenovirus-M3C, facilitated the directed differentiation of T1D-iPSCs toward pancreatic β-cells. The T3 + Vc group exhibited minimal neurogenin 3 expression, while the M3C + T3 + Vc group demonstrated maximal MAF bZIP transcription factor A expression. While insulin⁺ β-like cells differentiated from T1D-iPSCs displayed basal insulin secretion, they lacked the ability to respond to glucose stimulation, indicating functional immaturity compared to fully mature β-cells. These results underscore their potential as seed cells for β-cell replacement therapy in T1D.