scholarly journals Modern pancreatic islet encapsulation technologies for the treatment of type 1 diabetes

2021 ◽  
Vol 23 (4) ◽  
pp. 95-109
Author(s):  
P. S. Ermakova ◽  
E. I. Cherkasova ◽  
N. A. Lenshina ◽  
A. N. Konev ◽  
M. A. Batenkin ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cell Therapy ◽  
Pancreatic Islet ◽  
Cell Encapsulation ◽  
Β Cell ◽  
Islet Encapsulation ◽  
Insulin Dependent ◽  
Analytical Research ◽  
Insulin Replacement

The review includes the results of analytical research on the problem of application of pancreatic islet encapsulation technologies for compensation of type 1 diabetes. We present a review of modern encapsulation technologies, approaches to encapsulation strategies, insulin replacement technologies: auto-, allo- and xenotransplantation; prospects for cell therapy for insulin-dependent conditions; modern approaches to β-cell encapsulation, possibilities of optimization of encapsulation biomaterials to increase survival of transplanted cells and reduce adverse consequences for the recipient. The main problems that need to be solved for effective transplantation of encapsulated islets of Langerhans are identified and the main strategies for translating the islet encapsulation technology into medical reality are outlined.

scholarly journals A balancing act of optimising insulin dose and insulin sensitivity in type 1 diabetes

2011 ◽  
Vol 211 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Anna Krook
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Dose ◽  
Insulin Analogues ◽  
Therapeutic Modalities ◽  
Acting Insulin ◽  
Intermediate Acting Insulin ◽  
Insulin Dependent ◽  
Exogenous Delivery ◽  
Insulin Replacement

The incidence and prevalence of type 1, insulin dependent, diabetes is increasing worldwide, spurring efforts to develop and improve therapeutic modalities to improve clinical outcomes for patients. Patients with type 1 diabetes are absolutely dependent on exogenous insulin replacement. Despite advances with novel rapid-acting and intermediate-acting insulin analogues, the net result of exogenous delivery is non-physiologic with respect to both timing and the circulating insulin concentrations achieved. This leads to periods of hyperglycaemia and hypoglycaemia, both of which contribute negatively to overall clinical outcome. Thus, better understanding of optimal insulin regimens is of clinical relevance for patients with type 1 diabetes.

scholarly journals Imaging of β-Cell Mass and Insulitis in Insulin-Dependent (Type 1) Diabetes Mellitus

2012 ◽  
Vol 33 (6) ◽  
pp. 892-919 ◽  
Author(s):  
Valentina Di Gialleonardo ◽  
Erik F. J. de Vries ◽  
Marco Di Girolamo ◽  
Ana M. Quintero ◽  
Rudi A. J. O. Dierckx ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Cell Mass ◽  
Β Cell ◽  
Insulin Dependent ◽  
Dependent Type

scholarly journals A focus on the role of Pax4 in mature pancreatic islet β-cell expansion and survival in health and disease

2007 ◽  
Vol 40 (2) ◽  
pp. 37-45 ◽  
Author(s):  
Thierry Brun ◽  
Benoit R Gauthier
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Pancreatic Islet ◽  
Cell Expansion ◽  
Cell Mass ◽  
Cell Physiology ◽  
Β Cells ◽  
Β Cell

Blood glucose homeostasis is achieved by the regulation of insulin and glucagon secretion from the pancreatic islet β- and α-cells. Diabetes mellitus, which comprises a heterogeneous group of hyperglycaemic disorders, results mainly from inadequate mass and function of islet β-cells. Autoimmune destruction of β-cells causes type 1 diabetes, while type 2 is characterized by impaired insulin secretion and is often associated with diminished insulin action on its target tissues. Interestingly, similar to type 1 diabetes, a gradual loss of β-cell mass is observed in type 2 diabetes often requiring insulin therapy. Understanding the molecular mechanism that governs β-cell mass plasticity may provide a means to develop strategies to countera,ct β-cell death while increasing replication. Of particular interest is the islet-specific transcription factor paired box4 (Pax4) that was previously shown to be indispensable for the establishment of the β-cell lineage during development. However, recent accumulating evidence now suggest that Pax4 is also crucial for mature β-cell expansion and survival in response to physiological cues and that mutations or polymorphisms are associated with both type 1 and type 2 diabetes. In contrast, aberrant expression of Pax4 confers protection against apoptosis to insulinomas, whereas it promotes cell growth in lymphocytes. This review summarizes promising new published results supporting the important function of Pax4 in mature islet β-cell physiology and its contribution to pathophysiology when deregulated.

scholarly journals Differentiation of nestin-positive cells derived from bone marrow into pancreatic endocrine and ductal cells in vitro

2011 ◽  
Vol 209 (2) ◽  
pp. 193-201 ◽  
Author(s):  
Anna Milanesi ◽  
Jang-Won Lee ◽  
Qijin Xu ◽  
Laura Perin ◽  
John S Yu
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Type 1 Diabetes ◽  
Pancreatic Islet ◽  
Bone Marrow Stem Cells ◽  
Β Cells ◽  
Β Cell ◽  
Glucose Transporter 2

Promising results of pancreatic islet transplantation to treat type 1 diabetes mellitus, combined with severe shortage of donor pancreata, have spurred efforts to generate pancreatic islet-like cells and insulin-producing β-cells from various progenitor populations. In this study, we show for the first time that multipotent nestin-positive stem cells selected from rat bone marrow can be differentiated into pancreatic ductal and insulin-producing β-cells in vitro. We report an effective multistep protocol in a serum-free system, which could efficiently induce β-cell differentiation from multipotent nestin-positive bone marrow stem cells. To enhance the induction and differentiation toward pancreatic lineage we used trichostatin A, an important regulator of chromatin remodeling, and 5-aza 2′ deoxycytidine, an inhibitor of DNA methylase. All-trans retinoic acid was then utilized to promote pancreatic differentiation. We sequentially induced important transcription factor genes, such as Pdx1, Ngn3, and Pax6, following the in vivo development timeline of the pancreas in rats. Furthermore, in the final stage with the presence of nicotinamide, the induced cells expressed islet and ductal specific markers. The differentiated cells not only expressed insulin and glucose transporter 2, but also displayed a glucose-responsive secretion of the hormone. Our results delineate a new model system to study islet neogenesis and possible pharmaceutical targets. Nestin-positive bone marrow stem cells may be therapeutically relevant for β-cell replacement in type 1 diabetes.

scholarly journals Minireview: Glucagon in the Pathogenesis of Hypoglycemia and Hyperglycemia in Diabetes

Endocrinology ◽  
2012 ◽  
Vol 153 (3) ◽  
pp. 1039-1048 ◽  
Author(s):  
Philip E. Cryer
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Insulin Secretion ◽  
Pancreatic Islet ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Glucagon Secretion ◽  
Β Cell

Pancreatic islet α-cell glucagon secretion is critically dependent on pancreatic islet β-cell insulin secretion. Normally, a decrease in the plasma glucose concentration causes a decrease in β-cell insulin secretion that signals an increase in α-cell glucagon secretion during hypoglycemia. In contrast, an increase in the plasma glucose concentration, among other stimuli, causes an increase in β-cell insulin secretion that signals a decrease, or at least no change, in α-cell glucagon secretion after a meal. In absolute endogenous insulin deficiency (i.e. in type 1 diabetes and in advanced type 2 diabetes), however, β-cell failure results in no decrease in β-cell insulin secretion and thus no increase in α-cell glucagon secretion during hypoglycemia and no increase in β-cell insulin secretion and thus an increase in α-cell glucagon secretion after a meal. In type 1 diabetes and advanced type 2 diabetes, the absence of an increment in glucagon secretion, in the setting of an absent decrement in insulin secretion and an attenuated increment in sympathoadrenal activity, in response to falling plasma glucose concentrations plays a key role in the pathogenesis of iatrogenic hypoglycemia. In addition, there is increasing evidence that, in the aggregate, suggests that relative hyperglucagonemia, in the setting of deficient insulin secretion, plays a role in the pathogenesis of hyperglycemia in diabetes. If so, abnormal glucagon secretion is involved in the pathogenesis of both hypoglycemia and hyperglycemia in diabetes.

Engineering β Cell Replacement Therapies for Type 1 Diabetes: Biomaterial Advances and Considerations for Macroscale Constructs

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Michelle J. Quizon ◽  
Andrés J. García
Keyword(s):  
Type 1 Diabetes ◽  
Cell Therapy ◽  
Therapeutic Modality ◽  
Annual Review ◽  
Publication Date ◽  
Β Cell ◽  
Cell Replacement ◽  
Clinical Islet Transplantation ◽  
Current Paradigm

While significant progress has been made in treatments for type 1 diabetes (T1D) based on exogenous insulin, transplantation of insulin-producing cells (islets or stem cell–derived β cells) remains a promising curative strategy. The current paradigm for T1D cell therapy is clinical islet transplantation (CIT)—the infusion of islets into the liver—although this therapeutic modality comes with its own limitations that deteriorate islet health. Biomaterials can be leveraged to actively address the limitations of CIT, including undesired host inflammatory and immune responses, lack of vascularization, hypoxia, and the absence of native islet extracellular matrix cues. Moreover, in efforts toward a clinically translatable T1D cell therapy, much research now focuses on developing biomaterial platforms at the macroscale, at which implanted platforms can be easily retrieved and monitored. In this review, we discuss how biomaterials have recently been harnessed for macroscale T1D β cell replacement therapies. Expected final online publication date for the Annual Review of Pathology: Mechanisms of Disease, Volume 17 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals One repeated transplantation of allogeneic umbilical cord mesenchymal stromal cells in type 1 diabetes: an open parallel controlled clinical study

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Jing Lu ◽  
Shan-mei Shen ◽  
Qing Ling ◽  
Bin Wang ◽  
Li-rong Li ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Stromal Cells ◽  
Treated Group ◽  
Control Group ◽  
Adult Onset ◽  
Β Cell ◽  
Juvenile Onset ◽  
C Peptide

Abstract Background The preservation or restoration of β cell function in type 1 diabetes (T1D) remains as an attractive and challengeable therapeutic target. Mesenchymal stromal cells (MSCs) are multipotent cells with high capacity of immunoregulation, which emerged as a promising cell-based therapy for many immune disorders. The objective of this study was to examine the efficacy and safety of one repeated transplantation of allogeneic MSCs in individuals with T1D. Methods This was a nonrandomized, open-label, parallel-armed prospective study. MSCs were isolated from umbilical cord (UC) of healthy donors. Fifty-three participants including 33 adult-onset (≥ 18 years) and 20 juvenile-onset T1D were enrolled. Twenty-seven subjects (MSC-treated group) received an initial systemic infusion of allogeneic UC-MSCs, followed by a repeat course at 3 months, whereas the control group (n = 26) only received standard care based on intensive insulin therapy. Data at 1-year follow-up was reported in this study. The primary endpoint was clinical remission defined as a 10% increase from baseline in the level of fasting and/or postprandial C-peptide. The secondary endpoints included side effects, serum levels of HbA1c, changes in fasting and postprandial C-peptide, and daily insulin doses. Results After 1-year follow-up, 40.7% subjects in MSC-treated group achieved the primary endpoint, significantly higher than that in the control arm. Three subjects in MSC-treated group, in contrast to none in control group, achieved insulin independence and maintained insulin free for 3 to 12 months. Among the adult-onset T1D, the percent change of postprandial C-peptide was significantly increased in MSC-treated group than in the control group. However, changes in fasting or postprandial C-peptide were not significantly different between groups among the juvenile-onset T1D. Multivariable logistic regression assay indicated that lower fasting C-peptide and higher dose of UC-MSC correlated with achievement of clinical remission after transplantation. No severe side effects were observed. Conclusion One repeated intravenous dose of allogeneic UC-MSCs is safe in people with recent-onset T1D and may result in better islet β cell preservation during the first year after diagnosis compared to standard treatment alone. Trial registration ChiCTR2100045434. Registered on April 15, 2021—retrospectively registered, http://www.chictr.org.cn/

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