Abstract
There are approximately 1 billion prediabetic people worldwide, and the global cost for diabetes mellitus (DM) is estimated to be $825 billion. In regard to Type 1 DM, transplanting a whole pancreas or its islets has gained the attention of researchers in the last few decades. Recent studies showed that islet transplantation (ILT) containing insulin-producing β cells is the most notable advancement cure for Type 1 DM. However, this procedure has been hindered by shortage and lack of sufficient islet donors and the need for long-term immunosuppression of any potential graft rejection. The strategy of encapsulation may avoid the rejection of stem-cell-derived allogeneic islets or xenogeneic islets. This review article describes various biotechnology features in encapsulation-of-islet-cell therapy for humans, including the use of bile acids.
Highlights
Some authors have proposed protocols to define when to carry out islet or pancreas transplantation, and, in many scenarios, there is a degree of overlap
Out of the two scenarios, ILT is considered the future and the more promising solution, many strategies, including the encapsulation of islets andthe use of BAs or stem cells, are under investigation to overcome the limitations associated with ILT
Islet transplantation remains limited to Phase1/2 clinical trials with no widely used commercially available products
Summary
On transplanting the pancreas (whole organ or islets) in patients with T1DM with severe glycemic variability found it possible to restore the endocrine functions of the pancreas [5]. Islet transplantation ILT comes as an alternative, and is considered as an upgraded way to treat T1DM, in contrast to injection with insulin or whole-pancreas transplantation It requires approximately 2% (w/w) of the total pancreas (endocrine part) that contains β cells in a healthy person to be transplanted into a diabetic person with reasonable success. ILT can be infused using a catheter through the portal venous access, which represents a minimally invasive process and is associated with marginal or no complications [16] Another positive aspect of ILT is that it can deliver glycemic control without the risk of hypoglycemia and the use of exogenous insulin. This method is effective, seems simpler and less invasive, it does have some limitations
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