Autoimmune diseases represent one of the greatest challenges in modern medicine. In these diseases, the immune system, which should protect the body against external agents, loses its ability to properly distinguish between self and non-self and ends up attacking the patient’s own tissues. There are more than one hundred autoimmune diseases, including type 1 diabetes, lupus, rheumatoid arthritis, and Graves’ disease. According to a recent article published in Nature , up to 10% of the world’s population suffers from some type of autoimmune disease, and many of these diseases still lack a true cure.

Until now, medicine has primarily succeeded in managing the consequences of the disease. In many cases, medications that suppress the immune system are used, while in others, attempts are made to replace the function that an organ or tissue has lost. The problem is that these treatments can control the disease, but they don’t necessarily restore the damaged function permanently or correct the underlying mechanism that caused the disorder.

Regenerative medicine opens up a different possibility: replacing cells that have disappeared or become damaged and enabling the body itself to perform the lost function again .

1. iPS cells: converting an adult cell into a cell capable of regenerating tissues

One of the most promising tools to achieve this are induced pluripotent stem cells, known as iPS cells ( induced pluripotent stem cells ).

The idea is extraordinarily interesting. Instead of using cells from an embryo, an adult cell is taken from the patient—for example, a fat cell—and reprogrammed to return it to a pluripotent state. In that state, it can then be directed to become different cell types.

In this way, an adult cell can be transformed, through reprogramming techniques, into a source of new cells capable of replacing those that the patient has lost.

This offers a particularly important advantage: the cells can come from the patient themselves . This is why it’s called autologous therapy. Because the cells are genetically related to the recipient, the problem of immunological incompatibility that arises when cells from another person are transplanted can be avoided.

This possibility has enormous importance in regenerative medicine. A conventional transplant may require immunosuppressant drugs to prevent the body from rejecting the received tissue. These drugs, while sometimes essential, also weaken the immune system and can produce significant adverse effects.

The researchers’ goal, therefore, is to reach a point where patients can receive cells capable of repairing or replacing lost tissue without having to maintain intense immunosuppression indefinitely . The article in question points out that overcoming this need for immunosuppression is one of the major objectives of current research on stem cells and autoimmune diseases.

2. A particularly significant example: type 1 diabetes

Type 1 diabetes mellitus allows us to understand very well the potential of this strategy.

In this disease, the immune system destroys the beta cells of the pancreas, which are responsible for producing insulin. As a result, the patient needs to receive insulin for the rest of their life.

In 2024, a team of researchers published in Cell the preliminary results of a clinical trial in which induced pluripotent stem cells, derived from the patient, were used to produce pancreatic islets. These were subsequently transplanted back into the patient. The result was remarkably promising: the patient was able to maintain adequate glucose levels and no longer required exogenous insulin approximately 75 days after the transplant. At twelve months, she maintained stable glycemic control.

The case was particularly relevant because it involved cells obtained through an autologous strategy. In other words, it wasn’t simply a matter of replacing tissue with cells from a donor, but rather an attempt to build functional tissue from the patient’s own cells.

Nature now reports on the subsequent evolution of this case and notes that, almost three years later, the patient continues to progress favorably. The publication presents this result as an example of the new stage beginning in the development of cell therapies for autoimmune diseases.

3. The immunological issue: an advantage and, at the same time, a challenge

Here it is important to distinguish between two different problems.

The first is the rejection of foreign tissue . When cells come from another person, the immune system can recognize them as foreign and destroy them. Using iPS cells obtained from the patient themselves could avoid this problem because the cells are autologous.

The second problem is more complex: the autoimmune disease that caused the cell destruction may still exist .

In type 1 diabetes, for example, even if we manage to produce new beta cells from the patient’s own iPS cells, the immune system could again target and destroy them. Therefore, as noted in the Nature article , the major challenge lies in ensuring that the new cells survive without requiring permanent immunosuppression.

This means that iPS cells are not yet a definitive solution for all autoimmune diseases. However, they offer a strategy that combines two extraordinarily valuable possibilities: regenerating lost tissue and doing so using the patient’s own cells .

If researchers can also sufficiently re-educate or modify the immune response so that it stops attacking regenerated cells, we could be facing a profound change in the treatment of some autoimmune diseases.

4. An expensive treatment, but with a potentially huge benefit

There is still one major obstacle: the cost .

Obtaining patient-specific iPS cells, culturing them, reprogramming them, differentiating them, performing quality control, and then using them clinically are technically complex processes. Therefore, these treatments can currently be very expensive.

But the initial cost of a medical technology shouldn’t be the only criterion for assessing its potential. Many medical innovations began as extraordinarily expensive and complex and were later made more accessible through improved procedures, larger-scale production, and accumulated knowledge.

In this case, moreover, the potential benefit would be enormous if a chronic disease could be transformed into an effectively curable disease.

Let’s consider type 1 diabetes again. A person who currently depends on continuous insulin administration could, in the future, regain adequate production of this hormone through functional cells generated from their own cells. The benefit would not only be avoiding insulin injections. It could also mean reducing complications arising from the disease and, above all, restoring a biological function the patient had lost.

The same reasoning, with the corresponding differences, can be applied to other autoimmune diseases. If regenerative medicine succeeds not only in replacing destroyed cells but also in controlling the immune response responsible for their destruction, the impact on the quality of life of millions of people could be extraordinary.

Therefore, the economic challenge must be considered alongside the potential clinical and social benefits. A technology that is initially expensive can acquire enormous health relevance if it manages to provide a lasting solution to diseases that currently require lifelong treatment.

5. A key ethical advantage: there is no need to destroy embryos

In addition to their medical possibilities, iPS cells have a characteristic of great importance from an ethical point of view.

iPS cells are obtained by reprogramming adult somatic cells . Therefore, their use allows for the development of research and treatments based on pluripotent cells without having to resort to a human embryo to obtain them.

This difference is particularly relevant when considering the issue from a bioethical perspective that recognizes the intrinsic value of human life from its earliest stages of development.

Biomedical research seeks to alleviate suffering and cure diseases, but the goal of benefiting the patient does not eliminate the need to question the means used to achieve it. In this sense, iPS cells offer a particularly interesting avenue because they allow the pursuit of regenerative medicine goals without raising the same ethical issues associated with the use of embryonic stem cells.

The question can be formulated simply: if it is possible to obtain pluripotent cells from the patient’s own adult cells, why would it be necessary to resort to the destruction of human embryos?

iPS cells show that science can advance in regenerative medicine while simultaneously seeking therapeutic efficacy and respect for human life.

6. Science and ethics can advance together

The development of iPS cells is therefore a particularly interesting example of how scientific innovation can open paths that are both medically promising and ethically sound.

Their potential lies not only in their ability to transform into different cell types. Their true clinical interest lies in the possibility of replacing cells that the patient has lost using cells obtained from the patient’s own body , thus avoiding problems of immunological compatibility and, potentially, the need for immunosuppression.

The case of type 1 diabetes is still in its early stages of clinical practice and does not allow us to claim that a widespread cure exists. The first study published in Cell involved a single patient and was a phase I clinical trial; moreover, that patient had clinical circumstances that required continued immunosuppression, leaving open the question of whether the new cells could be sustained without it.

That’s why there’s still a lot of work to be done: demonstrating long-term safety, confirming the results in more patients, perfecting cell production, reducing costs, and above all, getting the immune system to stop destroying the regenerated cells.

But the horizon that opens up is extraordinary.

iPS cells allow us to envision a medicine that not only compensates for lost function for decades, but can also reconstruct it . Furthermore, they offer a research avenue that does not require sacrificing human embryos to obtain pluripotent cells.

The challenge in the coming years will be to move these treatments from highly specialized experimental trials to safe, effective, accessible, and economically sustainable therapies. If this is achieved, the benefit for patients could be enormous: not only controlling autoimmune diseases, but one day even modifying their course and, in certain cases, permanently restoring the functions that the disease had destroyed.

Regenerative medicine based on iPS cells thus represents one of the most exciting possibilities in contemporary medicine: using the patient’s own biological potential to repair their body, reduce immunological barriers, and advance towards treatments that simultaneously respect the dignity of the person and human life.