Pancreatic cell fate specification: insights into developmental mechanisms and their application for lineage reprogramming

Diabetes is a group of metabolic disorders, which results from insufficient functional pancreatic 13-cell mass either due to the autoimmune destruction of insulin producing 13-cells, or their death or de-differentiation as compensation for insulin resistance. The ability to reprogram cell types within close developmental proximity to 13-cells offers a strategy to replenish 13-cell mass and a future possible treatment of diabetes. Here, we review recent advances in the fields of pancreas development and lineage reprogramming. We also probe the possibility of using reprogrammed cells as an approach by which to further understand developmental mechanisms, in particular roadblocks to changing cell identity. Finally, we highlight fundamental challenges that need to be overcome to advance lineage reprogramming for generating pancreatic cells.