Treatment of diabetes by xenogeneic islets without immunosuppression. Use of a vascularized bioartificial pancreas.
Tight glycemic control by intensive insulin therapy effectively delays the onset and slows the progression of diabetic complications but is associated with frequent dose adjustments and a high incidence of hypoglycemia. Successful pancreas transplantation corrects abnormal glucose metabolism but subjects patients to morbidity and mortality associated with chronic immunosuppression. A vascularized artificial pancreas device containing pancreatic islets is designed to provide glycemic control without immunosuppression. We report here that devices seeded with porcine islets implanted into pancreatectomized severely diabetic dogs maintained a marked improvement in glycemic control with reduced exogenous insulin requirements for up to 9 months with improved glucose tolerance and a reduction in glycosylated hemoglobin levels. No immunosuppression was used. Thus, use of a vascularized artificial pancreas containing xenogeneic porcine islets could be an alternative to intensive insulin therapy and pancreatic transplantation in treating diabetic patients before the development of severe diabetic complications.
Maki
T
T
Division of Organ Transplantation, Department of Surgery, Deaconess Hospital and Harvard Medical School, Boston, MA, USA.
Otsu
I
I
O'Neil
J J
JJ
Dunleavy
K
K
Mullon
C J
CJ
Solomon
B A
BA
Monaco
A P
AP
D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D003921:Diabetes Mellitus, Experimental / Q000209:etiology / Q000601:surgery*; D004285:Dogs; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007332:Insulin Infusion Systems; D016381:Islets of Langerhans Transplantation; D010180:Pancreatectomy; D013552:Swine; D013997:Time Factors; D014183:Transplantation, Heterologous
D001786:Blood Glucose; D006442:Glycated Hemoglobin