[Show abstract][Hide abstract] ABSTRACT: In recent years, major effort has been made to differentiate embryonic stem cells, pancreatic ductal epithelial multipotent progenitor cells, and bone marrow stem cells into insulin secreting cells. Our previous work has also demonstrated the feasibility of inducing mesenchymal stem cells (MSC) to insulin secreting cells through overexpression of Pdx-1, a pancreas and islet-specific transcription factor that plays a major role in differentiation of islet β-cells during development (Yuan et al. in Mol Biol Rep 37:4023-4031, 2010). However, the levels of insulin secretion among these differentiated MSC were quite variable. The purpose of this study is to address the issue whether the insulin secretion level from the differentiated MSC lines are determined by the expression level of the Pdx-1 transgene. To do so, we have generated several differentiated MSC lines with stable transfection of the Pdx-1 gene. Using RT-PCR analysis and insulin secretion assay, we have analyzed Pdx-1 mRNA levels and insulin secretion from these stable MSC lines. Our results showed that Pdx-1 expression is absolutely required for the differentiation of MSC lines to insulin secreting cell lines. Furthermore, we demonstrated that the level of Pdx-1 expression is closely correlated with level of insulin mRNA and insulin secretion level in differentiated MSC stable cell lines. These findings suggest that the level of Pdx-1 expression plays a key role in induction of MSCs to insulin secreting cells.