Novel tissue-engineered islet transplant achieves insulin independence in type 1 diabetes

May 11, 2017
Fluorescence microscopy of islets in the omentum transplanted within the biologic scaffold.In red (insulin staining) and blue (DAPI nuclear staining). Credit: Diabetes Research Institute/University of Miami Miller School of Medicine

Scientists from the Diabetes Research Institute (DRI) at the University of Miami Miller School of Medicine have produced the first clinical results demonstrating that pancreatic islet cells transplanted within a tissue-engineered platform can successfully engraft and achieve insulin independence in type 1 diabetes. The findings, published in the May 11 issue of the New England Journal of Medicine, are part of an ongoing clinical study to test this novel strategy as an important step toward offering this life-changing cell replacement therapy to millions living with the disease.

Islet transplantation has demonstrated the ability to restore natural insulin production and eliminate severe hypoglycemia in people with type 1 diabetes. The have traditionally been implanted within the liver, but this transplant site poses some limitations for emerging applications, leading researchers to investigate other options. DRI scientists have focused on the omentum, an apron-like tissue covering abdominal organs, which is easily accessed with minimally invasive surgery and has the same blood supply and physiological drainage characteristics as the pancreas.

"The objective of testing this novel tissue-engineered platform is to initially determine that insulin-producing cells can function in this new site, and subsequently introduce additional technologies towards our ultimate goal to replace the pancreatic endocrine function lost in type 1 diabetes without the need for anti-rejection drugs, what we call the DRI BioHub," explains Camillo Ricordi, M.D., director of the DRI and the Stacy Joy Goodman Professor of Surgery, Distinguished Professor of Medicine, Professor of Biomedical Engineering, Microbiology and Immunology at the University of Miami Miller School. Dr. Ricordi also serves as director of the DRI's Cell Transplant Center.

This was the first successful tissue-engineered "mini pancreas" that has achieved long-term in a patient with type 1 diabetes. The biological platform was made by combining donor islets with the patient's own (autologous) blood plasma, which was laparoscopically layered onto the omentum. Clinical-grade thrombin was then layered over the islet/plasma mixture. Together, these substances create a gel-like material that sticks to the omentum and holds the islets in place. Over time, the body will absorb the gel, leaving the islets intact. The technique has been designed to minimize the inflammatory reaction that is normally observed when islets are implanted in the liver or in other sites with immediate contact to blood. The DRI's clinical trial, an important first step toward developing the BioHub mini organ, includes the immunosuppressive regimen currently used for clinical islet transplantation studies.

"The results thus far have shown that the omentum appears to be a viable site for islet implantation using this new platform technique," said lead author David Baidal, M.D., Assistant Professor of Medicine and member of the DRI's Clinical Cell Transplant team. "Data from our study and long-term follow up of additional omental islet transplants will determine the safety and feasibility of this strategy of , but we are quite excited about what we are seeing now."

In type 1 diabetes, the insulin-producing cells of the pancreas have been mistakenly destroyed by the immune system, requiring patients to manage their blood sugar levels through a daily regimen of insulin therapy. Islet transplantation has allowed many patients to live without the need for insulin injections after receiving a transplant of donor . Some patients who have received transplants at the DRI have been insulin independent for more than a decade, as DRI researchers have published.

Explore further: Mini-organ would mimic pancreas to treat type 1 diabetes

More information: Bioengineering of an Intraabdominal Endocrine Pancreas, New England Journal of Medicine (2017). www.nejm.org/doi/full/10.1056/NEJMc1613959

Related Stories

Mini-organ would mimic pancreas to treat type 1 diabetes

March 5, 2013
(HealthDay)— A new bioengineered, miniature organ dubbed the BioHub might one day offer people with type 1 diabetes freedom from their disease.

Cell study offers more diabetic patients chance of transplant

August 29, 2013
Diabetic patients could benefit from a breakthrough that enables scientists to take cells from the pancreas and change their function to produce insulin.

New procedure could improve success rate of cell transplant to cure type 1 diabetes

April 4, 2016
New research suggests pretreating cells with a peptide hormone may improve the success rate of pancreatic islet cell transplants, a procedure that holds great promise for curing Type 1 diabetes. The results will be presented ...

Artificial pancreas therapy performs well in pilot study

November 20, 2015
Researchers are reporting a breakthrough toward developing an artificial pancreas as a treatment for diabetes and other conditions by combining mechanical artificial pancreas technology with transplantation of islet cells, ...

Pancreatic islets infusion for diabetes patient being readied for procedure in Japan

May 16, 2012
The Japanese Pancreas and Islet Transplantation Association (JPITA) is preparing for the nation's first transplantation of pancreatic islets from a brain-dead donor to a patient with Type 1 diabetes, it was learned Saturday.

Recommended for you

Artificial pancreas performs well in clinical trial

October 16, 2017
During more than 60,000 hours of combined use of a novel artificial pancreas system, participants in a 12-week, multi-site clinical trial showed significant improvements in two key measures of well-being in people living ...

Omega-6 fats may help prevent type 2 diabetes

October 11, 2017
The risk of developing type 2 diabetes could be significantly reduced by eating a diet rich in omega-6 polyunsaturated fats, a new study suggests.

Where there's type 1 diabetes, celiac disease may follow

October 10, 2017
(HealthDay)—Parents of young children with type 1 diabetes need to be on the lookout for symptoms of another autoimmune condition—celiac disease, new research suggests.

Type 1 diabetes and the microbiota—MAIT cells as biomarkers and new therapeutic targets

October 10, 2017
Together with colleagues from AP-HP Necker–Enfants Malades Hospital in Paris, scientists from the Cochin Institute (CNRS / INSERM / Paris Descartes University) have discovered that the onset of type 1 diabetes is preceded ...

Likely new treatment target identified for diabetic retinopathy

October 10, 2017
In oxygen-compromising conditions like diabetes, the body grows new blood vessels to help, but the result is often leaky, dysfunctional vessels that make bad matters worse.

Healing molecule discovery could reduce limb amputations for diabetes patients

October 4, 2017
Scientists have discovered new insights into a molecule which is part of the body's tissue repair system, in a finding which could help treat non-healing wounds and injuries, such as diabetic foot.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.