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Duct cells in development, regeneration, and transplantation: charting a path to new islets
Type 1 diabetes mellitus is an autoimmune disease characterized by the destruction of insulin-producing β-cells in the islets of Langerhans. A promising curative strategy involves the replacement of β-cells, such as through islet transplantation. However, limited donor tissue restricts its scalability, creating the need for alternative sources of β-cells. Whether adult human pancreatic duct cells—epithelial cells lining the ducts—can act as β-cell progenitors remains debated. This thesis investigates their plasticity potential.
We first examined the role of non-endocrine cells in clinical islet transplants. While high-purity grafts showed better early outcomes, no sustained metabolic benefit was observed in lower-purity grafts, offering no clear evidence of new β-cell formation in this context. To further explore duct cell plasticity potential, we developed a 3D organoid culture system for human islet-depleted pancreatic tissue. These organoids exhibited stem-like...
Show moreType 1 diabetes mellitus is an autoimmune disease characterized by the destruction of insulin-producing β-cells in the islets of Langerhans. A promising curative strategy involves the replacement of β-cells, such as through islet transplantation. However, limited donor tissue restricts its scalability, creating the need for alternative sources of β-cells. Whether adult human pancreatic duct cells—epithelial cells lining the ducts—can act as β-cell progenitors remains debated. This thesis investigates their plasticity potential.
We first examined the role of non-endocrine cells in clinical islet transplants. While high-purity grafts showed better early outcomes, no sustained metabolic benefit was observed in lower-purity grafts, offering no clear evidence of new β-cell formation in this context. To further explore duct cell plasticity potential, we developed a 3D organoid culture system for human islet-depleted pancreatic tissue. These organoids exhibited stem-like properties and limited capacity for endocrine differentiation. Furthermore, we show that endocrine differentiation from duct cells can be improved using β-cell neogenesis agents, optimized lentiviral gene delivery, and studied transcriptional regulators such as SOX9 during human pancreas development, revealing insights into β-cell development.
Together, these findings provide a detailed analysis of duct cell plasticity and contribute to ongoing efforts to develop regenerative therapies for T1DM.
- All authors
- Balak, J.R.A.
- Supervisor
- Koning, E.J.P. de
- Co-supervisor
- Carlotti, F.
- Committee
- Pijl, H.; Chuva de Sousa Lopes, S.M.; De Leu, N.; Alwayn, I.P.J.; Spee, B.; Spijker, H.S.
- Qualification
- Doctor (dr.)
- Awarding Institution
- Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
- Date
- 2025-05-16
- ISBN (print)
- 9789082870985