Type 1 diabetes is an autoimmune disease caused by the destruction of insulin-producing beta cells in the pancreas. Insulin is a hormone responsible for regulating blood glucose levels by moving glucose out of the bloodstream. Without it, cells starve and glucose accumulates in the blood, resulting in high blood sugar levels and symptoms such as dehydration, weight loss, and ketoacidosis. Despite ongoing research, there is no cure yet. Patients must use insulin injections or infusions to control their blood sugar, in combination with carefully adjusted food consumption and physical activity levels.
Current research strategies include utilizing immunotherapy, regenerating islet cells (clusters of cells in the pancreas which contain beta cells), transplanting islet cells, and preventing diabetes complications. In their study, scientists from the Diabetes Research Institute (DRI) at the University of Miami Miller School of Medicine reported that they transplanted pancreatic islet cells using a tissue-engineered platform. Their transplant was successfully engrafted and achieved long-term insulin independence in a patient with type 1 diabetes.
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As published in their study, the DRI scientists turned their attention to the omentum, an apron-like sheet of fatty tissue covering the abdominal organs. They focused on this site due to its accessibility by surgery and its drainage system which resembles that of the pancreas. The scientists aimed to determine whether the islet transplants could produce insulin at this site. Ultimately, the goal, according to DRI director Camillo Ricordi, M.D., is to “replace the pancreatic endocrine function lost in type 1 diabetes without the need for anti-rejection drugs.”
The tissue-engineered biological platform that the scientists used combined islets from donors with the patient’s own blood plasma. After layering this islet and plasma mixture onto the omentum using laparoscopic surgery, the researchers added a layer of thrombin, an enzyme which aids in blood clotting, on top. The layers combined to form a gel-like substance that held the islets in place on the omentum. Over time, as the patient’s body absorbed the gel, the islets would remain in place. This platform minimized the inflammatory response that usually occurs when islets are implanted in the liver or other sites in the body.
The scientists demonstrated that the omentum is a viable site for islet transplantation using this novel technique. They will continue to determine the long-term practicality and safety of the technique through long-term follow-up of additional islet transplants at the omentum. Islet transplants allow patients with type 1 diabetes to possibly live without the need for continual insulin injections for more than a decade. Even though this study focused on type 1 diabetes, researchers are making great strides in understanding both types of diabetes and continually making progress toward finding novel and effective treatments which have the potential to benefit the millions affected by diabetes.
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