Islet xenotransplantation using porcine islets is an attractive approach to overcoming the challenge of donor shortage. Since pancreas transplantation requires major surgery, pancreas transplantation alone for the treatment of severe hypoglycemia is less common.ĭonor shortage is the major limitation to the promotion of islet transplantation for the treatment of unstable T1DM. Islet transplantation alone is the most frequently adopted form of islet transplantation, while simultaneous pancreas and kidney transplantation, which has been established for the treatment of diabetic nephropathy, is the most frequently adopted form of pancreas transplantation. Beta-cell replacement therapy, including pancreas and islet transplantation, is the best treatment to avoid severe hypoglycemia while maintaining normal HbA1c. Hypoglycemia can be a serious issue especially hypoglycemia with a lack of unawareness and severe hypoglycemia, which are life-threatening complications. Although this approach reduces HbA1c, the increasing the frequency of hypoglycemic events is a disadvantage. Intensive insulin therapy is the standard treatment for type 1 diabetes mellitus (T1DM). Islet xenotransplantation porcine islets donor shortage porcine endogenous retrovirus (PERV) designated pathogen free pig severe hypoglycemic episodes type 1 diabetes 1. Encapsulated porcine islet xenotransplantation seems a promising therapeutic approach and recent scientific advances, including immune suppression protocols, gene editing technologies, and blastocyst complementation technology, offer the potential to further promote this technique for the treatment of T1DM. In 2016, encapsulated porcine islet xenotransplantation was reported to provide clinical benefit for T1DM patients. This study demonstrated the safety of islet xenotransplantation although the efficacy was limited. In addition, compliance with regulatory guidance is important to prevent the spread of zoonotic infections.A clinical trial of encapsulated porcine islet xenotransplantation for the treatment of T1DM under comprehensive regulation was reported in 2014. DPF status donor pigs and monitoring for the presence of porcine endogenous retrovirus (PERV) are necessary to prevent this complication. One of the major concerns of islet xenotransplantation is zoonotic infection. Compared with embryonic stem (ES) cell- and induced pluripotent stem (iPS) cell-derived insulin producing cells, porcine islets are associated with a depth of clinical experience and evidence of safety and efficacy. Porcine islets offer several advantages over human islets, including unlimited and on-demand supplies, a higher quality of islets from healthy donors, greater safety with designated pathogen-free (DPF) donor pigs and the potential to improve survival with gene modification technologies. Islet xenotransplantation using porcine islets is a promising solution to this issue. Allogeneic islet transplantation has been established to prevent severe hypoglycemia in unstable T1DM patients although there is a serious shortage of donors. More than 10 million people worldwide suffer from type 1 diabetes mellitus (T1DM). This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited. Islet Xenotransplantation for the Treatment of Type 1 Diabetes. Recommended citation: Shimoda M, Matsumoto S. Special Issue: Current Advancement of Islet Cell Transplantation in the Treatment of Diabetes Mellitus Received: Febru| Accepted: Ap| Published: April 25, 2018
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