Pancreatic Islet Transplantation, Hope and Hype in Treatment of Type I Diabetes
سال انتشار: 1397
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 305
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شناسه ملی سند علمی:
NSCMRMED03_029
تاریخ نمایه سازی: 30 دی 1397
چکیده مقاله:
Type 1 diabetes (T1D) is an autoimmune disease that the immunesystem destroys insulin-producing pancreatic beta cells, resulted inhigh serum blood glucose levels with pathologic processes lead to longtermcomplications. Pancreatic islet transplantation has emerged as analternative therapy for diabetic patients. This procedure does not require major surgery but still lifelong immunosuppression is required to preservethe transplanted islets from immune system attack. Regarding the vasttherapeutic advantages, some practical challenges still remain that affectthe wide use of this therapy. The major challenge of islet transplantationis the lack of donor for pancreatic islet. Nowadays brain-dead donors arethe major source of islets for transplantation. Although non-heart-beatingdonors may also be introduced as potential sources for islet isolation innear future. Scientists are working massively on some other approachessuch as the differentiation of beta cells from human embryonic stem cellsor induced pluripotent stem cells. Many islets are destroyed in the earlypost-transplantation time due to apoptosis made by damage to isletsduring islet preparation steps. Thus, any improvements in the steps ofpancreas procurement, islet isolation and culture lead to increased isletyield and/or its functional parameters. Furthermore, pancreatic islets arehighly vascularized tissue with a huge capillary network. Despite thehigh demand of islet cells for blood supply there is a 2-week lag phase forrevascularization of islet which promotes islet cell loss in this time period.Besides, another most challenging issue about islet transplantation wouldbe the presence of both allogenic immune reactions and previouslyexisting autoimmunity against islets which leads to allograft rejection oftransplanted islets. The newly emerged works ideally choose immunemodulationor immune-isolation approach that could target both typesof immune reactions. There are several strategies that may cover eachof the mentioned problems of islet transplantation, but a combinatoryapproach may be the ideal solution to shift this therapy to the routinetreatments for diabetes.
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نویسندگان
Ensiyeh Hajizadeh-Saffar
Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran