Alternative transplantation sites for islet transplantation

Pellegrini, Silvia

doi:10.1016/b978-0-12-814833-4.00065-4

Cited by 7 publications

(12 citation statements)

References 128 publications

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“…Deep investigations of the physiology of the native endocrine pancreatic niche have helped to understand the principal features useful for bioengineering vascularized endocrine pancreas. In addition, other evidence has been derived from the comprehension of the mechanisms involved in the failure of engraftment upon transplantation at different sites ( 7 , 11 ).…”

Section: Tuning the Endocrine Nichementioning

confidence: 99%

“…Based on this evidence, β-cell replacement strategies are focused on finding vascularized sites, evaluating alternative transplantation sites compared to the liver, or preconditioning strategies that increase vessel density at the implantation site. Owing to the failure to find alternative transplantation sites, the preconditioning strategy has gained ground, especially by exploiting biocompatible materials ( 7 , 11 , 81 , 82 ). In particular, engineering a transplantation site to increase vascularization is thought to be suitable for ameliorating the engraftment and function of endocrine pancreatic grafts ( 83 ) ( Figure 2 ).…”

Section: Tuning the Endocrine Nichementioning

confidence: 99%

“…However, only a small percentage of recipients acquire insulin independence after intrahepatic islet transplantation. A gradual loss of both graft function and insulin independence was observed within 5 years of islet implantation ( 7 , 8 , 11 ). Despite the short-term function, the results derived from the recipients demonstrated that reestablishing endocrine pancreatic function has the potential to restore fine endogenous control over glucose homeostasis, which cannot be precisely mimicked by closed-loop artificial pancreas devices ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, to avoid immunological reactions against the graft in the post-transplant phase, life-long immunosuppressant administration is provided, which in turn can provoke kidney failure and increase cancer risk and infection ( 15 ). In recent years, alternative transplantation sites have been proposed to increase the success rate of allogeneic islet transplantation; however, to date, no one has shown superior outcomes compared to the intrahepatic site ( 6 , 7 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

“…TE technologies may also give the chance to recreate endocrine pancreas using alternative endocrine sources, such as pluripotent stem cells (PSCs) or xenogeneic source appropriately modified, favoring the exploration of their function and the feasibility of the approach in clinical practice ( 11 , 24 ). Finally, the flexibility of TE technologies might help overcome the systemic administration of immunosuppressive drugs by combining novel immunosuppressive strategies to locally achieve an immune-privileged transplantation site ( 15 , 23 , 25 , 26 ).…”

Section: Introductionmentioning

confidence: 99%

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Bioengineering the Vascularized Endocrine Pancreas: A Fine-Tuned Interplay Between Vascularization, Extracellular-Matrix-Based Scaffold Architecture, and Insulin-Producing Cells

Pignatelli¹,

Campo

Neroni

et al. 2022

Transpl Int

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Intrahepatic islet transplantation is a promising β-cell replacement strategy for the treatment of type 1 diabetes. Instant blood-mediated inflammatory reactions, acute inflammatory storm, and graft revascularization delay limit islet engraftment in the peri-transplant phase, hampering the success rate of the procedure. Growing evidence has demonstrated that islet engraftment efficiency may take advantage of several bioengineering approaches aimed to recreate both vascular and endocrine compartments either ex vivo or in vivo. To this end, endocrine pancreas bioengineering is an emerging field in β-cell replacement, which might provide endocrine cells with all the building blocks (vascularization, ECM composition, or micro/macro-architecture) useful for their successful engraftment and function in vivo. Studies on reshaping either the endocrine cellular composition or the islet microenvironment have been largely performed, focusing on a single building block element, without, however, grasping that their synergistic effect is indispensable for correct endocrine function. Herein, the review focuses on the minimum building blocks that an ideal vascularized endocrine scaffold should have to resemble the endocrine niche architecture, composition, and function to foster functional connections between the vascular and endocrine compartments. Additionally, this review highlights the possibility of designing bioengineered scaffolds integrating alternative endocrine sources to overcome donor organ shortages and the possibility of combining novel immune-preserving strategies for long-term graft function.

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Section: Tuning the Endocrine Nichementioning

confidence: 99%