title: Diabetes Is Reversed in a Murine Model by Marginal Mass Syngeneic Islet Transplantation Using a Subcutaneous Cell Pouch Device.
abstract: BACKGROUND
  Islet transplantation is a successful β-cell replacement therapy for selected patients with type 1 diabetes mellitus. Although high rates of early insulin independence are achieved routinely, long-term function wanes over time. Intraportal transplantation is associated with procedural risks, requires multiple donors, and does not afford routine biopsy. Stem cell technologies may require potential for retrievability, and graft removal by hepatectomy is impractical. There is a clear clinical need for an alternative, optimized transplantation site. The subcutaneous space is a potential substitute, but transplantation of islets into this site has routinely failed to reverse diabetes. However, an implanted device, which becomes prevascularized before transplantation, may alter this equation.
  
  
  METHODS
  Syngeneic mouse islets were transplanted subcutaneously within Sernova Corp's Cell Pouch (CP). All recipients were preimplanted with CPs 4 weeks before diabetes induction and transplantation. After transplantation, recipients were monitored for glycemic control and glucose tolerance.
  
  
  RESULTS
  Mouse islets transplanted into the CP routinely restored glycemic control with modest delay and responded well to glucose challenge, comparable to renal subcapsular islet grafts, despite a marginal islet dose, and normoglycemia was maintained until graft explantation. In contrast, islets transplanted subcutaneously alone failed to engraft. Islets within CPs stained positively for insulin, glucagon, and microvessels.
  
  
  CONCLUSIONS
  The CP is biocompatible, forms an environment suitable for islet engraftment, and offers a potential alternative to the intraportal site for islet and future stem cell therapies.
authors: 1 Clinical Islet Transplant Program, Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada. 2 Sernova Corp. London, ON, Canada. 3 Department of Surgery, Robarts Research Institute, University of Western Ontario, ON, Canada. 4 Department of Surgery, University of Alberta, Edmonton, AB, Canada.
authors: Andrew R
authors: AR
authors: Pepper
authors: Rena
authors: R
authors: Pawlick
authors: Boris
authors: B
authors: Gala-Lopez
authors: Amanda
authors: A
authors: MacGillivary
authors: Delfina M
authors: DM
authors: Mazzuca
authors: David J G
authors: DJ
authors: White
authors: Philip M
authors: PM
authors: Toleikis
authors: A M James
authors: AM
authors: Shapiro
mesh_terms: D000818:Animals; D021522:Bioartificial Organs; D001786:Blood Glucose / Q000378:metabolism; D003921:Diabetes Mellitus, Experimental / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D004867:Equipment Design; D005934:Glucagon / Q000378:metabolism; D007328:Insulin / Q000378:metabolism; D007515:Islets of Langerhans / Q000098:blood supply / Q000378:metabolism / Q000601:surgery*; D016381:Islets of Langerhans Transplantation / Q000295:instrumentation*; D008297:Male; D008807:Mice, Inbred BALB C; D055806:Microvessels / Q000503:physiopathology; D018919:Neovascularization, Physiologic; D019397:Pancreas, Artificial; D013997:Time Factors; D014185:Transplantation, Isogeneic
chemical_list: D001786:Blood Glucose; D007328:Insulin; D005934:Glucagon