Site - Engineering a home for islets
What is Islet Transplantation?
Sustain - Ensuring islet cell survival
Supply - Creating more islets
Site - Engineering a Home for Islets
In clinical islet transplantation the insulin-producing cells have traditionally been implanted within the patient’s liver but this transplant site poses some limitations, leading researchers to explore other options. DRI scientists are investigating areas within the body that can not only house transplanted islets, but also sites that might support beneficial components for the cells’ long-term health and protection from the immune system. This unique approach – to engineer a mini-endocrine pancreas as a potential site of islet transplantation – is an important first step in the DRI BioHub strategy.
Exploring Alternative Transplant Sites
Taking the lead from the human body, where islets are naturally dispersed throughout the pancreas, scientists have begun their exploration of alternative sites that might offer comparable cell spacing. DRI researchers are investigating several areas of the body and are currently focused on the omentum, an apron-like tissue that covers abdominal organs and is easily accessed with minimally invasive surgery. In addition, it has the same blood supply and physiological drainage characteristics as the pancreas.
To recreate the “natural” environment, DRI researchers engineered a biological scaffold by combining the recipient’s plasma with thrombin, a commonly-used clotting enzyme. Together, these substances create a gel-like platform that can stick to the omentum and hold the islets in place.
Groundbreaking preliminary data shows that islets in the omentum can initially engraft and generated improved blood sugar control. This image on the below shows islets implanted within the engineered scaffold.
Testing the Tissue-Engineered Platform
In 2014, the DRI received permission from the Food and Drug Administration (FDA) to proceed with a Phase I/II clinical trial to test islets transplanted within the scaffold on the omentum in a small group of patients with type 1 diabetes. The goal of this pilot study is to initially determine if islets can function in this new site before introducing additional components to help restore insulin production without the need for anti-rejection drugs. This pilot study involves the immunosuppressive regimen currently used for clinical islet transplantation and is currently in progress.
The DRI is developing a tissue-engineered mini-organ that may serve as a potential site of islet transplantation, or other insulin-producing cell source, and can allow for the integration of different technologies to eliminate the need for life-long anti-rejection drugs.