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Nanotechnology in Stem Cell Regenerative Therapy and Its Applications
Published in Harishkumar Madhyastha, Durgesh Nandini Chauhan, Nanopharmaceuticals in Regenerative Medicine, 2022
Multipotent pancreatic stem cells (PSCs) are isolated from the human foetal pancreas, derived from the foregut endoderm and reformed into progenitor lineages, essential for the growing pancreas (Jiang and Morahan 2014). Islet cell transplantation can reverse the damage of pancreatic islets cells in Type 1 diabetes (Ma et al. 2008).
Surgical management of diabetes
Published in Janet Titchener, Diabetes Management, 2020
Islet cell transplantation is complicated by the need for immunosuppression. This introduces a number of signficant side effects including anaemia, weight loss, hypertension, hyperlipidaemia and nephrotoxity as well as an increased risk of developing cancer. This procedure is still experimental and therefore limited to the management of people with type 1 diabetes who are relatively healthy but have severe hypoglycaemic unawareness that prevents them from holding a job or participating in the usual activities of daily living.
Hematopoietic Stem Cell Transplantation as Treatment for Type 1 Diabetes
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Júlio C. Voltarelli, Richard K. Burt, Norma Kenyon, Dixon B. Kaufman, Elizabeth C. Squiers
Pancreas or islet cell transplantation is the only treatment of type 1 diabetes that reestablishes an insulin independent normoglycemic state. The down side of this therapy is a limited supply of donors, as well as treatment related mortality from infectious and neoplastic complications secondary to life-long immune suppression.
Emerging drugs for the treatment of type 1 diabetes mellitus: a review of phase 2 clinical trials
Published in Expert Opinion on Emerging Drugs, 2023
Allogenic islet transplantation has been a treatment option for people with T1DM who have disabling severe hypoglycemia and/or who have end-stage renal disease needing renal transplant. Islet cell transplantation is considered minimally invasive but still carries the risk from immunosuppression. Donor availability is the main limiting factor in allogenic islet transplant from cadaveric samples as two or three donor pancreases are typically required for one islet transplant. Stem cell–derived islet cells potentially could be a renewable, uncontaminated, and unlimited supply of islet cells for transplantation. Pre-clinical studies have demonstrated that cells differentiated from human pluripotent stem cells (hPSCs) display insulin secretory properties similar to human islets [135,136]. Phase 1 and phase 2 trials investigating the efficacy and safety of hPSC-derived islets are underway (NCT02239354, NCT03163511, and NCT02939118). In the initial report from Henry et al., VC-01, stem cell–derived islet cells encapsulated in a device, was safe and tolerated with minimal adverse events related to the surgical insertion. In addition, the delivery device provided protection against the host immune system with no evidence of immune rejection despite participants not being on immunosuppressive medications [137].
Over ten-year insulin independence following single allogeneic islet transplant without T-cell depleting antibody induction
Published in Islets, 2018
Jack Williams, Nicholas Jacus, Kevin Kavalackal, Kirstie K. Danielson, Rebecca S. Monson, Yong Wang, Jose Oberholzer
In 2000, Shapiro et al. reported improvement in the efficacy of islet transplantation as a functional cure for type 1 diabetes (T1D) using the Edmonton Protocol, which involved standardizing islet cell isolation procedures, the number (dose) of transplanted islets, and the use of steroid-free immunosuppression.1 However, only 1 of the 36 recipients from the International Trial of the Edmonton Protocol remained insulin independent after three years.2 With continuing progress in both islet isolation and clinical management after transplant, the rate of insulin independence following islet transplantation has steadily improved. For patients transplanted between 2007 and 2010, 44% were insulin independent at three years.3 More recently, our research group demonstrated that 60% of patients remained insulin independent at five years, without the use of T-cell depleting antibody induction immunosuppression.4 Despite these improvements, in a substantial number of cases, islet cell transplantation is still followed by a gradual decrease in the production of insulin and partial (to complete) graft loss.5 Long-term maintenance of islet graft function will be central to islet transplantation becoming a viable treatment option for T1D patients.
Effects of platelet-rich plasma on the pancreatic islet survival and function, islet transplantation outcome and pancreatic pdx1 and insulin gene expression in streptozotocin-induced diabetic rats
Published in Growth Factors, 2020
Marzieh Nemati, Narges Karbalaei, Pooneh Mokarram, Farzaneh Dehghani
Diabetes mellitus is one of the most common endocrine metabolic diseases with progressive incidence in the world (Gubitosi-Klug 2014). Increasing the morbidity and mortality of diabetes has caused this disorder to be one of the most costly diseases affecting the global health system (Cusick et al. 2005). Insulin deficiency and hyperglycemia in type 1 diabetes, which accounts for less than 10% of total diabetic people, are due to autoimmune destruction of pancreatic islet β-cells. Available treatment for people with type 1 diabetes is daily insulin therapy, but studies have shown that it is not an effective treatment to control the blood glucose variations and completely elimination of long term complications of diabetes (Bottino et al. 2002; Gubitosi-Klug 2014). Beta cell regeneration and replacement of new beta cells by stem cell, whole pancreas and islet transplantation are the proposed treatments for diabetes and re-establishing the endogenous insulin secretion (Lakey et al. 2001; Nathan 2014; Solis et al. 2019). Studies have shown that pancreas and islet cell transplantation in type I diabetes mellitus are potentially curative treatments to correct metabolic abnormalities and prevent diabetic complications because of sustained and stable release of insulin after transplantation (Bruni et al. 2014; He et al. 2016; Wallner et al. 2016; Smink and de Vos 2018). Compared to pancreas transplantation, islet transplantation is a relatively non-invasive, simple technique with low morbidity with the opportunity for culture of islet and long-term storage of it through cryopreservation (Nanji and Shapiro 2006; Saidi 2012; Wallner et al. 2016). However, a major limitation of islet transplantation as standard treatment in large scale is the lack of available quantities of viable and functional islets in both pretransplantation and posttransplantation due to multiple factors, including loss of vasculature, hypoxia, inflammation, apoptosis, or necrosis (Nanji and Shapiro 2006; Lai et al. 2009; Shapiro 2012).