Breakthrough in T1D treatment: Improving islet transplantation

Researchers funded by Breakthrough T1D in the US have published promising new data that could help to improve islet transplantation for people with T1D.

Transplanting islets under the skin:

Researchers based in New York, USA have been looking into how donor islet cells could be transplanted under a person’s skin. Islets, short for islets of Langerhans, are clusters of cells in the pancreas that produce insulin and other hormones like glucagon. An islet transplant involves transferring islets from donor pancreases to people with T1D to restore insulin production, often reducing the need for insulin injections temporarily.

The research team hope that by placing transplanted islet cells under the skin, instead of in the liver, like they usually are, they will be able to reduce the number of transplant patients that go on to need insulin injections in the long-term. Injecting transplant islet cells under the skin is attractive because there is a lot of space, and it is easily accessible.

Why blood supply is so important for cells?

Islet cells are scattered across the pancreas, making up only about 2% of the total weight of the pancreas, but they receive up to 20% of the pancreas blood supply due to the number and density of blood vessels around the islets. We know that within hours of removing islet cells from the pancreas the structures responsible for maintaining blood flow begin to breakdown.

It is important that all cells in the body get enough blood, this helps them to do their jobs properly. A good blood supply makes sure that cells get all the oxygen and nutrients they need as well as taking away any waste products. Making sure that transplanted islet cells get enough blood supply is an ongoing challenge for scientists.

This team of researchers developed a method using specially engineered human blood vessel cells (R-VECs) to form a network of blood vessels around the islets before they are transplanted. During testing they found that islet cells treated with R-VECs were better at controlling blood sugar levels in diabetic mice when compared to islet cells not treated with R-VECs.

At a glance:

• Lab Results: The islets with R-VECs showed normal insulin production in response to glucose.
• Animal Testing: When transplanted into diabetic mice, these islets helped manage blood sugar levels, and the mice’s blood sugar returned to normal.
• Adaptability: The R-VECs adapted to the islets, forming a supportive environment similar to natural blood vessels.

What is next for these researchers:

This method could improve the success of islet transplantation for diabetes treatment. However, this research is in very early stages and more research and clinical trials are needed to confirm the effectiveness and safety of this approach before it can be tested in people with T1D. The goal is to offer a new, reliable treatment option for managing T1D.