Frontiers in transplantation of insulin-secreting tissue for diabetes mellitus.
Transplantation of insulin-secreting tissue represents a physiologic approach to reverse diabetes mellitus. Pancreas transplants yield a remarkable enhancement in quality of life and appear to modify the devastating neurovascular complications of diabetes. A more attractive approach is transplantation of insulin-secreting cells, a procedure of low invasiveness with the exciting prospect of modulating graft immunogenicity before transplantation, so as to minimize requirements for toxic immunosuppressive drugs. The Surgical-Medical Research Institute at the University of Alberta in Edmonton, and several others centres throughout the world, has demonstrated that islet cell transplants can reverse insulin dependence and induce remarkable glycemic stability for several years. However, widespread success has been denied because of insufficient donor tissue, early failures to reverse insulin dependence and the loss of graft function with time. Promising new research approaches to these problems are reviewed, including xenogeneic sources of cells, engineering islet cells with genes that induce expression of immunoprotective molecules, and neogenesis factors that may sustain populations of transplanted beta cells.
Warnock
G L
GL
Department of Surgery, Surgical-Medical Research Institute, University of Alberta, Edmonton.
D000416:Alberta; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000502:physiology*; D011183:Postoperative Complications / Q000097:blood / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome
D001786:Blood Glucose