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Transplantation of Encapsulated Pancreatic Islets as a Treatment for Patients with Type 1 Diabetes Mellitus.

Qi M - Adv Med (2014)

Bottom Line: Encapsulation of pancreatic islets has been proposed and investigated for over three decades to improve islet transplantation outcomes and to eliminate the side effects of immunosuppressive medications.Of the numerous encapsulation systems developed in the past, microencapsulation have been studied most extensively so far.A wide variety of materials has been tested for microencapsulation in various animal models (including nonhuman primates or NHPs) and some materials were shown to induce immunoprotection to islet grafts without the need for chronic immunosuppression.

View Article: PubMed Central - PubMed

Affiliation: Division of Transplantation/Department of Surgery, University of Illinois at Chicago, IL 60612, USA ; Department of Diabetes and Metabolic Diseases Research, Beckman Research Institute of the City of Hope, 1500 E. Duarte Road, Duarte, CA 91010, USA.

ABSTRACT
Encapsulation of pancreatic islets has been proposed and investigated for over three decades to improve islet transplantation outcomes and to eliminate the side effects of immunosuppressive medications. Of the numerous encapsulation systems developed in the past, microencapsulation have been studied most extensively so far. A wide variety of materials has been tested for microencapsulation in various animal models (including nonhuman primates or NHPs) and some materials were shown to induce immunoprotection to islet grafts without the need for chronic immunosuppression. Despite the initial success of microcapsules in NHP models, the combined use of islet transplantation (allograft) and microencapsulation has not yet been successful in clinical trials. This review consists of three sections: introduction to islet transplantation, transplantation of encapsulated pancreatic islets as a treatment for patients with type 1 diabetes mellitus (T1DM), and present challenges and future perspectives.

No MeSH data available.


Related in: MedlinePlus

Human islet isolation procedure. (1) Pancreas perfused with enzymatic solution; (2) pancreatic tissue digested in Ricordi isolation chamber; (3) digested tissue purified in COBE 2991 cell separator; (4) purified islets cultured at 37°C/5% CO2.
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fig1: Human islet isolation procedure. (1) Pancreas perfused with enzymatic solution; (2) pancreatic tissue digested in Ricordi isolation chamber; (3) digested tissue purified in COBE 2991 cell separator; (4) purified islets cultured at 37°C/5% CO2.

Mentions: Islet transplantation is considered as an improved way to cure T1DM in comparison with insulin injection and whole pancreas transplantation. Absence of insulin in patients with T1DM forces them to use exogenous insulin to maintain normal blood glucose, which can delay or prevent health complications. Theoretically, exogenous insulin can replace β cells in islets, but practically, the insulin injection cannot maintain stable blood glucose levels. Pancreatic islet transplantation is a procedure to selectively transplant the endocrine part of a whole pancreas (about 2% of the pancreas mass). In comparison with whole pancreas transplantation, islet transplantation can be conducted via a minimally invasive approach and is associated with minimal or no complications. The islets can be infused via a catheter that has percutaneous portal venous access [13]. Therefore, this procedure can be applied to a wider range of recipients. More importantly, the islet transplantation can provide glycemic control without exogenous insulin and risks of hypoglycemia. The first experimental islet transplantation was conducted in a rodent model in 1972; several years after this a whole pancreas transplantation was initiated in a human patient [14]. Generally speaking, clinical allogeneic islet transplantation involves four chronological steps: procurement of donor pancreas, isolation of pancreatic islets (Figure 1 and Table 1), assessment of isolated islets (Table 2), and transplantation of harvested islets and patient followup.


Transplantation of Encapsulated Pancreatic Islets as a Treatment for Patients with Type 1 Diabetes Mellitus.

Qi M - Adv Med (2014)

Human islet isolation procedure. (1) Pancreas perfused with enzymatic solution; (2) pancreatic tissue digested in Ricordi isolation chamber; (3) digested tissue purified in COBE 2991 cell separator; (4) purified islets cultured at 37°C/5% CO2.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590955&req=5

fig1: Human islet isolation procedure. (1) Pancreas perfused with enzymatic solution; (2) pancreatic tissue digested in Ricordi isolation chamber; (3) digested tissue purified in COBE 2991 cell separator; (4) purified islets cultured at 37°C/5% CO2.
Mentions: Islet transplantation is considered as an improved way to cure T1DM in comparison with insulin injection and whole pancreas transplantation. Absence of insulin in patients with T1DM forces them to use exogenous insulin to maintain normal blood glucose, which can delay or prevent health complications. Theoretically, exogenous insulin can replace β cells in islets, but practically, the insulin injection cannot maintain stable blood glucose levels. Pancreatic islet transplantation is a procedure to selectively transplant the endocrine part of a whole pancreas (about 2% of the pancreas mass). In comparison with whole pancreas transplantation, islet transplantation can be conducted via a minimally invasive approach and is associated with minimal or no complications. The islets can be infused via a catheter that has percutaneous portal venous access [13]. Therefore, this procedure can be applied to a wider range of recipients. More importantly, the islet transplantation can provide glycemic control without exogenous insulin and risks of hypoglycemia. The first experimental islet transplantation was conducted in a rodent model in 1972; several years after this a whole pancreas transplantation was initiated in a human patient [14]. Generally speaking, clinical allogeneic islet transplantation involves four chronological steps: procurement of donor pancreas, isolation of pancreatic islets (Figure 1 and Table 1), assessment of isolated islets (Table 2), and transplantation of harvested islets and patient followup.

Bottom Line: Encapsulation of pancreatic islets has been proposed and investigated for over three decades to improve islet transplantation outcomes and to eliminate the side effects of immunosuppressive medications.Of the numerous encapsulation systems developed in the past, microencapsulation have been studied most extensively so far.A wide variety of materials has been tested for microencapsulation in various animal models (including nonhuman primates or NHPs) and some materials were shown to induce immunoprotection to islet grafts without the need for chronic immunosuppression.

View Article: PubMed Central - PubMed

Affiliation: Division of Transplantation/Department of Surgery, University of Illinois at Chicago, IL 60612, USA ; Department of Diabetes and Metabolic Diseases Research, Beckman Research Institute of the City of Hope, 1500 E. Duarte Road, Duarte, CA 91010, USA.

ABSTRACT
Encapsulation of pancreatic islets has been proposed and investigated for over three decades to improve islet transplantation outcomes and to eliminate the side effects of immunosuppressive medications. Of the numerous encapsulation systems developed in the past, microencapsulation have been studied most extensively so far. A wide variety of materials has been tested for microencapsulation in various animal models (including nonhuman primates or NHPs) and some materials were shown to induce immunoprotection to islet grafts without the need for chronic immunosuppression. Despite the initial success of microcapsules in NHP models, the combined use of islet transplantation (allograft) and microencapsulation has not yet been successful in clinical trials. This review consists of three sections: introduction to islet transplantation, transplantation of encapsulated pancreatic islets as a treatment for patients with type 1 diabetes mellitus (T1DM), and present challenges and future perspectives.

No MeSH data available.


Related in: MedlinePlus