共 34 条
Human islet-derived precursor cells are mesenchymal stromal cells that differentiate and mature to hormone-expressing cells in vivo
被引:84
作者:

Davani, Behrous
论文数: 0 引用数: 0
h-index: 0
机构:
NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA

Ikonomou, Laertis
论文数: 0 引用数: 0
h-index: 0
机构:
NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA

Raaka, Bruce M.
论文数: 0 引用数: 0
h-index: 0
机构:
NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA

Geras-Raaka, Elizabeth
论文数: 0 引用数: 0
h-index: 0
机构:
NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA

Morton, Russell A.
论文数: 0 引用数: 0
h-index: 0
机构:
NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA

Marcus-Samuels, Bernice
论文数: 0 引用数: 0
h-index: 0
机构:
NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA

Gershengorn, Marvin C.
论文数: 0 引用数: 0
h-index: 0
机构:
NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA
机构:
[1] NIH, NIDDK, Clin Endocrinol Branch, Bethesda, MD 20892 USA
来源:
关键词:
islet precursor cells;
mesenchymal stromal cells;
insulin;
cell replacement therapy;
diabetes;
D O I:
10.1634/stemcells.2007-0323
中图分类号:
Q813 [细胞工程];
学科分类号:
摘要:
Islet transplantation offers improved glucose homeostasis in diabetic patients, but transplantation of islets is limited by the supply of donor pancreases. Undifferentiated precursors hold promise for cell therapy because they can expand before differentiation to produce a large supply of functional insulin-producing cells. Previously, we described proliferative populations of human islet-derived precursor cells (hIPCs) from adult islets. To show the differentiation potential of hIPCs, which do not express insulin mRNA after at least 1,000-fold expansion, we generated epithelial cell clusters (ECCs) during 4 days of differentiation in vitro. After transplantation into mice, 22 of 35 ECC preparations differentiated and matured into functional cells that secreted human C-peptide in response to glucose. Transcripts for insulin, glucagon, and somatostatin in recovered ECC grafts increased with time in vivo, reaching levels approximately 1% of those in adult islets. We show that hIPCs are mesenchymal stromal cells (MSCs) that adhere to plastic, express CD73, CD90, and CD105, and can differentiate in vitro into adipocytes, chondrocytes, and osteocytes. Moreover, we find a minor population of CD105(+)/ CD73(+)/ CD90(+) cells in adult human islets (prior to incubation in vitro) that express insulin mRNA at low levels. We conclude that hIPCs are a specific type of pancreas-derived MSC that are capable of differentiating into hormone-expressing cells. Their ability to mature into functional insulin-secreting cells in vivo identifies them as an important adult precursor or stem cell population that could offer a virtually unlimited supply of human islet-like cells for replacement therapy in type 1 diabetes.
引用
收藏
页码:3215 / 3222
页数:8
相关论文
共 34 条
[1]
No evidence for mouse pancreatic β-cell epithelial-mesenchymal transition in vitro
[J].
Atouf, Fouad
;
Park, Cheol Hong
;
Pechhold, Klaus
;
Ta, Malancha
;
Choi, Yong
;
Lumelsky, Nadya L.
.
DIABETES,
2007, 56 (03)
:699-702

Atouf, Fouad
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDK, Diabet Branch, NIH, Bethesda, MD USA NIDDK, Diabet Branch, NIH, Bethesda, MD USA

Park, Cheol Hong
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDK, Diabet Branch, NIH, Bethesda, MD USA NIDDK, Diabet Branch, NIH, Bethesda, MD USA

Pechhold, Klaus
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDK, Diabet Branch, NIH, Bethesda, MD USA NIDDK, Diabet Branch, NIH, Bethesda, MD USA

Ta, Malancha
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDK, Diabet Branch, NIH, Bethesda, MD USA NIDDK, Diabet Branch, NIH, Bethesda, MD USA

Choi, Yong
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDK, Diabet Branch, NIH, Bethesda, MD USA NIDDK, Diabet Branch, NIH, Bethesda, MD USA

Lumelsky, Nadya L.
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDK, Diabet Branch, NIH, Bethesda, MD USA NIDDK, Diabet Branch, NIH, Bethesda, MD USA
[2]
In vitro cultivation of human islets from expanded ductal tissue
[J].
Bonner-Weir, S
;
Taneja, M
;
Weir, GC
;
Tatarkiewicz, K
;
Song, KH
;
Sharma, A
;
O'Neil, JJ
.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA,
2000, 97 (14)
:7999-8004

Bonner-Weir, S
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA

Taneja, M
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA

Weir, GC
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA

Tatarkiewicz, K
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA

Song, KH
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA

Sharma, A
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA

O'Neil, JJ
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA
[3]
New sources of pancreatic β-cells
[J].
Bonner-Weir, S
;
Weir, GC
.
NATURE BIOTECHNOLOGY,
2005, 23 (07)
:857-861

论文数: 引用数:
h-index:
机构:

Weir, GC
论文数: 0 引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Joslin Diabet Ctr, Sect Islet Transplantat & Cell Biol, Boston, MA 02215 USA Harvard Univ, Sch Med, Joslin Diabet Ctr, Sect Islet Transplantat & Cell Biol, Boston, MA 02215 USA
[4]
Modulation of specific beta cell gene (re)expression during in vitro expansion of human pancreatic islet cells
[J].
Bouckenooghe, T
;
Vandewalle, B
;
Lukowiak, B
;
Kerr-Conte, J
;
Belaïch, S
;
Gmyr, V
;
Dubois, M
;
Riachy, R
;
Pattou, F
.
CELL TRANSPLANTATION,
2003, 12 (07)
:799-807

Bouckenooghe, T
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Vandewalle, B
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Lukowiak, B
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Kerr-Conte, J
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Belaïch, S
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Gmyr, V
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Dubois, M
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Riachy, R
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France

Pattou, F
论文数: 0 引用数: 0
h-index: 0
机构:
Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France Fac Med Lille, INSERM, ERIM 0106, F-59045 Lille, France
[5]
Islet-derived fibroblast-like cells are not derived via epithelial-mesenchymal transition from Pdx-1 or insulin-positive cells
[J].
Chase, Lucas G.
;
Ulloa-Montoya, Fernando
;
Kidder, Benjamin L.
;
Verfaillie, Catherine M.
.
DIABETES,
2007, 56 (01)
:3-7

Chase, Lucas G.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA

Ulloa-Montoya, Fernando
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA

Kidder, Benjamin L.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA

Verfaillie, Catherine M.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA Univ Minnesota, Stem Cell Inst, McGuire Translat Res Facil, Minneapolis, MN 55455 USA
[6]
In vitro trans-differentiation of rat mesenchymal cells into insulin-producing cells by rat pancreatic extract
[J].
Choi, KS
;
Shin, JS
;
Lee, JJ
;
Kim, YS
;
Kim, SB
;
Kim, CW
.
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS,
2005, 330 (04)
:1299-1305

Choi, KS
论文数: 0 引用数: 0
h-index: 0
机构:
Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea

Shin, JS
论文数: 0 引用数: 0
h-index: 0
机构:
Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea

Lee, JJ
论文数: 0 引用数: 0
h-index: 0
机构:
Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea

Kim, YS
论文数: 0 引用数: 0
h-index: 0
机构:
Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea

Kim, SB
论文数: 0 引用数: 0
h-index: 0
机构:
Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea

Kim, CW
论文数: 0 引用数: 0
h-index: 0
机构:
Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea Korea Univ, Sch Life Sci & Biotechnol, Seoul 136701, South Korea
[7]
Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement
[J].
Dominici, M.
;
Le Blanc, K.
;
Mueller, I.
;
Slaper-Cortenbach, I.
;
Marini, F. C.
;
Krause, D. S.
;
Deans, R. J.
;
Keating, A.
;
Prockop, D. J.
;
Horwitz, E. M.
.
CYTOTHERAPY,
2006, 8 (04)
:315-317

Dominici, M.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Le Blanc, K.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Mueller, I.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Slaper-Cortenbach, I.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Marini, F. C.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Krause, D. S.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Deans, R. J.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Keating, A.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Prockop, D. J.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy

Horwitz, E. M.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Modena & Reggio Emilia, Lab Cell Biol & Adv Canc Therapy, Dept Hematol Oncol, I-41100 Modena, Italy
[8]
Multipotential nestin and Isl-1 positive mesenchymal stem cells isolated from human pancreatic islets
[J].
Eberhardt, Michael
;
Salmon, Patrick
;
Von Mach, Marc-Alexander
;
Hengstler, Jan Georg
;
Brulport, Marc
;
Linscheid, Philippe
;
Seboek, Dalma
;
Oberholzer, Jose
;
Barbero, Andrea
;
Martin, Ivan
;
Mueller, Beat
;
Trono, Didier
;
Zulewski, Henryk
.
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS,
2006, 345 (03)
:1167-1176

Eberhardt, Michael
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Salmon, Patrick
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Von Mach, Marc-Alexander
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Hengstler, Jan Georg
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Brulport, Marc
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Linscheid, Philippe
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Seboek, Dalma
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Oberholzer, Jose
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Barbero, Andrea
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Martin, Ivan
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Mueller, Beat
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Trono, Didier
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland

Zulewski, Henryk
论文数: 0 引用数: 0
h-index: 0
机构: Univ Basel Hosp, Dept Res, Div Endocrinol Diabet & Clin Nutr, Basel, Switzerland
[9]
Generation and expansion of multipotent mesenchymal progenitor cells from cultured human pancreatic islets
[J].
Gallo, R.
;
Gambelli, F.
;
Gava, B.
;
Sasdelli, F.
;
Tellone, V.
;
Masini, M.
;
Marchetti, P.
;
Dotta, F.
;
Sorrentino, V.
.
CELL DEATH AND DIFFERENTIATION,
2007, 14 (11)
:1860-1871

Gallo, R.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Siena, Dept Internal Med Endocrine & Metab Sci & Biochem, Diabet Unit, I-53100 Siena, Italy

Gambelli, F.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Siena, Dept Internal Med Endocrine & Metab Sci & Biochem, Diabet Unit, I-53100 Siena, Italy

Gava, B.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Siena, Dept Internal Med Endocrine & Metab Sci & Biochem, Diabet Unit, I-53100 Siena, Italy

Sasdelli, F.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Siena, Dept Internal Med Endocrine & Metab Sci & Biochem, Diabet Unit, I-53100 Siena, Italy

Tellone, V.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Siena, Dept Internal Med Endocrine & Metab Sci & Biochem, Diabet Unit, I-53100 Siena, Italy

Masini, M.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Siena, Dept Internal Med Endocrine & Metab Sci & Biochem, Diabet Unit, I-53100 Siena, Italy

论文数: 引用数:
h-index:
机构:

Dotta, F.
论文数: 0 引用数: 0
h-index: 0
机构: Univ Siena, Dept Internal Med Endocrine & Metab Sci & Biochem, Diabet Unit, I-53100 Siena, Italy

论文数: 引用数:
h-index:
机构:
[10]
Epithelial-to-mesenchymal transition generates proliferative human islet precursor cells
[J].
Gershengorn, MC
;
Hardikar, AA
;
Wei, CJ
;
Geras-Raaka, E
;
Marcus-Samuels, B
;
Raaka, BM
.
SCIENCE,
2004, 306 (5705)
:2261-2264

Gershengorn, MC
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA

Hardikar, AA
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA

Wei, CJ
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA

Geras-Raaka, E
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA

Marcus-Samuels, B
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA

Raaka, BM
论文数: 0 引用数: 0
h-index: 0
机构:
NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA NIDDKD, Clin Endocrinol Branch, NIH, Bethesda, MD 20892 USA