Abstract
Type 1 diabetes (T1D) is a widespread disease, affecting approximately 41.5 million people worldwide. It is generally treated with exogenous insulin, maintaining physiological blood glucose levels but also leading to long-term therapeutic complications. Pancreatic islet cell transplantation offers a potential alternative treatment to insulin injections. Shortage of human organ donors has raised the interest for porcine islet xenotransplantation. Neonatal porcine islets are highly available, can proliferate and mature in vitro as well as after transplantation in vivo. Despite promising preclinical results, delayed insulin secretion caused by immaturity and immunogenicity of the neonatal porcine islets remains a challenge for their clinical application. Multipotent mesenchymal stromal cells (MSCs) are known to have pro-angiogenic, anti-inflammatory and immunomodulatory effects. The current state of research emphasizes the great potential of co-culture and co-transplantation of islet cells with MSCs. Studies have shown enhanced islet proliferation and maturation, insulin secretion and graft survival, resulting in an improved graft outcome. This review summarizes the immunomodulatory and anti-inflammatory properties of MSC in the context of islet transplantation.
Highlights
Human pancreatic islet transplantation through portal vein infusion, is a current clinical beta-cell replacement therapy to treat patients with advanced Type I Diabetes (T1D)
Clinical application of pig to human islet transplantation will depend on genetic engineering of pigs to overcome immune barriers and to reduce risks of pathogen infection of porcine viruses [1]
This review summarizes the immunomodulatory and anti-inflammatory properties of mesenchymal stromal cells (MSCs) in the context of islet transplantation and evokes some of the current challenges of islet xenotransplantation
Summary
Human pancreatic islet transplantation through portal vein infusion, is a current clinical beta-cell replacement therapy to treat patients with advanced Type I Diabetes (T1D). A variety of other tissues contain MSCs, including adipose tissue, umbilical cord blood, Wharton’s jelly, amniotic fluid, endometrium, skin and skeletal muscle [14,15,16,17,18,19,20,21,22]. It remains unknown which source is most suitable for the clinical use in the context of islet cell transplantation and further research is needed concerning this matter. MSCs have been shown to perform various beneficial functions, making them highly interesting for application in cell-based therapy, especially for islet transplantation
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