Function and composition of pancreatic islet cell implants in omentum of type 1 diabetes patients.

Autor: Van Hulle F; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium., De Groot K; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium., Hilbrands R; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Diabetes Clinic, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium., Van de Velde U; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Diabetes Clinic, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium., Suenens K; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium., Stangé G; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium., De Mesmaeker I; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Beta Cell Bank, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium., De Paep DL; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Beta Cell Bank, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.; Department of Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium., Ling Z; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Beta Cell Bank, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium., Roep B; Department Internal Medicine, Leiden University Medical Center - LUMC, Leiden, The Netherlands., Gillard P; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium., Pipeleers D; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium., Keymeulen B; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Diabetes Clinic, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium., Jacobs-Tulleneers-Thevissen D; Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Department of Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2022 Mar; Vol. 22 (3), pp. 927-936. Date of Electronic Publication: 2021 Nov 16.
DOI: 10.1111/ajt.16884
Abstrakt: Intraportal (IP) islet cell transplants can restore metabolic control in type 1 diabetes patients, but limitations raise the need for establishing a functional beta cell mass (FBM) in a confined extrahepatic site. This study reports on function and composition of omental (OM) implants after placement of islet cell grafts with similar beta cell mass as in our IP-protocol (2-5.10 6 beta cells/kg body weight) on a scaffold. Four of seven C-peptide-negative recipients achieved low beta cell function (hyperglycemic clamp [HGC] 2-8 percent of controls) until laparoscopy, 2-6 months later, for OM-biopsy and concomitant IP-transplant with similar beta cell dose. This IP-transplant increased HGC-values to 15-40 percent. OM-biopsies reflected the composition of initial grafts, exhibiting varying proportions of endocrine-cell-enriched clusters with more beta than alpha cells and leucocyte pole, non-endocrine cytokeratin-positive clusters surrounded by leucocytes, and scaffold remnants with foreign body reaction. OM-implants on a polyglactin-thrombin-fibrinogen-scaffold presented larger endocrine clusters with infiltrating endothelial cells and corresponded to the higher HGC-values. No activation of cellular immunity to GAD/IA2 was measured post-OM-transplant. Establishment of a metabolically adequate FBM in omentum may require a higher beta cell number in grafts but also elimination of their immunogenic non-endocrine components as well as local conditioning that favors endocrine cell engraftment and function.
(© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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