PANCREATIC ISLET TRANSPLANTATION IN THE TREATMENT OF TYPE I DIABETES
Abstract
Type I diabetes is a chronic autoimmune disease characterized by a complete lack of insulin secretion due to damage to pancreatic beta cells. Despite the development of new methods of glycemic monitoring and intensive insulin therapy, traditional treatment does not lead to a complete cure, and therefore does not completely rule out the occurrence of complications such as hyper- or hypoglycemia. An unconventional therapeutic method is pancreatic islet transplantation, which makes it possible to restore the physiological secretion of insulin by the pancreas. This article presents the history of the development of islet transplantation and reviews the latest discoveries regarding the technique of islet isolation and transplantation, current transplant sites, and the difficulties associated with donor shortages and immunosuppression. Also discussed are ways to improve the survival and function of transplanted islets, which include the use of mesenchymal stem cells, encapsulation techniques and Treg lymphocytes. Special attention is given to research on insulin-producing cells derived from human pluripotent stem cells, and the results of clinical trials demonstrating the benefits of this method in reducing the risk of hypoglycemia and increasing metabolic control are summarized. Failures associated with achieving incomplete independence from exogenous insulin are also discussed. Pancreatic islet transplantation remains a promising, albeit still experimental, treatment for type I diabetes, requiring further research and refinement.
Materials and Methods: This article presents a comprehensive review of literature derived from the PubMed database, encompassing studies published between 2018 and 2025.
References
Pilśniak A, Otto-Buczkowska E. Type 1 diabetes - What's new in prevention and therapeutic strategies? Pediatr Endocrinol Diabetes Metab. 2023;29(3):196-201. doi: 10.5114/pedm.2023.132028. PMID: 38031834; PMCID: PMC10679919.
KAWABATA, Y., IKEGAMI, H., FUJISAWA, T., NOSO, S., ASANO, K., HIROMINE, Y. i OGIHARA, T. (2006), A Second Component of HLA-Linked Susceptibility to Type 1 Diabetes Maps to Class I Region. Annals of the New York Academy of Sciences, 1079: 278-284. https://doi.org/10.1196/annals.1375.042
K. Piątek ,, Cukrzyca-wyzwanie zdrowotne XXI wieku’’, INFOS nr 3(316) ,22 lutego 2024
Haak T, Gölz S, Fritsche A, Füchtenbusch M, Siegmund T, Schnellbächer E, Klein HH, Uebel T, Droßel D. Therapy of Type 1 Diabetes. Exp Clin Endocrinol Diabetes. 2019 Dec;127(S 01):S27-S38. doi: 10.1055/a-0984-5696. Epub 2019 Dec 20. PMID: 31860925.
Tripathi BK, Srivastava AK. Diabetes mellitus: complications and therapeutics. Med Sci Monit. 2006 Jul;12(7):RA130-47. Epub 2006 Jun 28. PMID: 16810145.
Forum Medycyny Rodzinnej 2019; 13 (2): 45–94, u „Wytyczne Kolegium Lekarzy Rodzinnych w Polsce i Polskiego Towarzystwa Diabetologicznego 2019”
Wang Q, Huang YX, Liu L, Zhao XH, Sun Y, Mao X, Li SW. Pancreatic islet transplantation: current advances and challenges. Front Immunol. 2024 Jun 3;15:1391504. doi: 10.3389/fimmu.2024.1391504. PMID: 38887292; PMCID: PMC11180903.
Cayabyab F, Nih LR, Yoshihara E. Advances in Pancreatic Islet Transplantation Sites for the Treatment of Diabetes. Front Endocrinol (Lausanne). 2021 Sep 13;12:732431. doi: 10.3389/fendo.2021.732431. PMID: 34589059; PMCID: PMC8473744.
Yu M, Agarwal D, Korutla L, May CL, Wang W, Griffith NN, Hering BJ, Kaestner KH, Velazquez OC, Markmann JF, Vallabhajosyula P, Liu C, Naji A. Islet transplantation in the subcutaneous space achieves long-term euglycaemia in preclinical models of type 1 diabetes. Nat Metab. 2020 Oct;2(10):1013-1020. doi: 10.1038/s42255-020-0269-7. Epub 2020 Sep 7. PMID: 32895576; PMCID: PMC7572844.
Ilegems E, Berggren PO. The Eye as a Transplantation Site to Monitor Pancreatic Islet Cell Plasticity. Front Endocrinol (Lausanne). 2021 Apr 23;12:652853. doi: 10.3389/fendo.2021.652853. PMID: 33967961; PMCID: PMC8104082.
Path G i in. Komórki macierzyste w leczeniu cukrzycy – skupienie się na komórkach macierzystych mezenchymalnych. Metabolizm. 2019;90:1–15. doi: 10.1016/j.metabol.2018.10.005.
Tao T i in. Inżynieria ludzkich organoidów wysepek z iPSC przy użyciu platformy organ-on-chip. Lab Chip. 2019;19(6):948–958. doi: 10.1039/c8lc01298a.
Czarnecka Z, Dadheech N, Razavy H, Pawlick R, Shapiro AMJ. The Current Status of Allogenic Islet Cell Transplantation. Cells. 2023 Oct 10;12(20):2423. doi: 10.3390/cells12202423. PMID: 37887267; PMCID: PMC10605704.
Chen S, Du K, Zou C. Current progress in stem cell therapy for type 1 diabetes mellitus. Stem Cell Res Ther. 2020 Jul 8;11(1):275. doi: 10.1186/s13287-020-01793-6. PMID: 32641151; PMCID: PMC7346484.
de Klerk E, Hebrok M. Stem Cell-Based Clinical Trials for Diabetes Mellitus. Front Endocrinol (Lausanne). 2021 Feb 26;12:631463. doi: 10.3389/fendo.2021.631463. PMID: 33716982; PMCID: PMC7953062.
Kabakchieva P, Assyov Y, Gerasoudis S, Vasilev G, Peshevska-Sekulovska M, Sekulovski M, Lazova S, Miteva DG, Gulinac M, Tomov L, Velikova T. Islet transplantation-immunological challenges and current perspectives. World J Transplant. 2023 Jun 18;13(4):107-121. doi: 10.5500/wjt.v13.i4.107. PMID: 37388389; PMCID: PMC10303418.
McCall M, Shapiro AM. Islet cell transplantation. Semin Pediatr Surg. 2014 Apr;23(2):83-90. doi: 10.1053/j.sempedsurg.2014.03.006. Epub 2014 May 2. PMID: 24931353.
Othonos N, Choudhary P. Who Should Be Considered for Islet Transplantation Alone? Curr Diab Rep. 2017 Apr;17(4):23. doi: 10.1007/s11892-017-0847-6. Erratum in: Curr Diab Rep. 2017 Apr;17(4):29. doi: 10.1007/s11892-017-0862-7. PMID: 28293906; PMCID: PMC5350263.
Thierry Berney a b c d,Charles H. Wassmer a b,Fanny Lebreton jest,Kevin Bellofatto a,Laura Mar Fonseca jest,Juliette Bignard i,Królowa Hanna a,Andrea Peloso b,Ekaterina Berishvili a c e doi.org/10.1016/j.lpm.2022.104139
Kuo CH, Li HY. Pancreatic islet transplantation in type 1 diabetes: Current state and future perspectives. J Diabetes Investig. 2023 Feb;14(2):183-185. doi: 10.1111/jdi.13942. Epub 2022 Nov 9. PMID: 36349993; PMCID: PMC9889686.
Klak M, Gomółka M, Kowalska P, Cichoń J, Ambrożkiewicz F, Serwańska-Świętek M, Berman A, Wszoła M. Type 1 diabetes: genes associated with disease development. Cent Eur J Immunol. 2020;45(4):439-453. doi: 10.5114/ceji.2020.103386. Epub 2021 Feb 7. PMID: 33658892; PMCID: PMC7882399.
Rickels MR, Robertson RP. Pancreatic Islet Transplantation in Humans: Recent Progress and Future Directions. Endocr Rev. 2019 Apr 1;40(2):631-668. doi: 10.1210/er.2018-00154. PMID: 30541144; PMCID: PMC6424003.
Päth G, Perakakis N, Mantzoros CS, Seufert J. Stem cells in the treatment of diabetes mellitus - Focus on mesenchymal stem cells. Metabolism. 2019 Jan;90:1-15. doi: 10.1016/j.metabol.2018.10.005. Epub 2018 Oct 18. PMID: 30342065.
Dadheech N, James Shapiro AM. Human Induced Pluripotent Stem Cells in the Curative Treatment of Diabetes and Potential Impediments Ahead. Adv Exp Med Biol. 2019;1144:25-35. doi: 10.1007/5584_2018_305. PMID: 30569414.
Lablanche S, Vantyghem MC, Kessler L, Wojtusciszyn A, Borot S, Thivolet C, Girerd S, Bosco D, Bosson JL, Colin C, Tetaz R, Logerot S, Kerr-Conte J, Renard E, Penfornis A, Morelon E, Buron F, Skaare K, Grguric G, Camillo-Brault C, Egelhofer H, Benomar K, Badet L, Berney T, Pattou F, Benhamou PY; TRIMECO trial investigators. Islet transplantation versus insulin therapy in patients with type 1 diabetes with severe hypoglycaemia or poorly controlled glycaemia after kidney transplantation (TRIMECO): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2018 Jul;6(7):527-537. doi: 10.1016/S2213-8587(18)30078-0. Epub 2018 May 15. PMID: 29776895.
Vantyghem MC, de Koning EJP, Pattou F, Rickels MR. Advances in β-cell replacement therapy for the treatment of type 1 diabetes. Lancet. 2019 Oct 5;394(10205):1274-1285. doi: 10.1016/S0140-6736(19)31334-0. Epub 2019 Sep 15. PMID: 31533905; PMCID: PMC6951435.
Rech Tondin A, Lanzoni G. Islet Cell Replacement and Regeneration for Type 1 Diabetes: Current Developments and Future Prospects. BioDrugs. 2025 Mar;39(2):261-280. doi: 10.1007/s40259-025-00703-7. Epub 2025 Feb 7. PMID: 39918671; PMCID: PMC11906537.
Marfil-Garza BA, Shapiro AMJ, Kin T. Clinical islet transplantation: Current progress and new frontiers. J Hepatobiliary Pancreat Sci. 2021 Mar;28(3):243-254. doi: 10.1002/jhbp.891. Epub 2021 Feb 11. PMID: 33417749.
Gruessner RWG. The current state of clinical islet transplantation. Lancet Diabetes Endocrinol. 2022 Jul;10(7):476-478. doi: 10.1016/S2213-8587(22)00138-3. Epub 2022 May 16. PMID: 35588758.
Kochar IS, Jain R. Pancreas transplant in type 1 diabetes mellitus: the emerging role of islet cell transplant. Ann Pediatr Endocrinol Metab. 2021 Jun;26(2):86-91. doi: 10.6065/apem.2142012.006. Epub 2021 Jun 30. PMID: 34218630; PMCID: PMC8255858.
Odhaib SA, Mohammed AG, Iraqi H. Whole Pancreas and Islet Cells Transplantation for Patients with Type 1 Diabetes Mellitus: A Mini-Review and Middle East-North Africa Experience. Curr Diabetes Rev. 2022 Aug 29. doi: 10.2174/1573399819666220829091241. Epub ahead of print. PMID: 36043740.
Lee J, Yoon KH. β cell replacement therapy for the cure of diabetes. J Diabetes Investig. 2022 Nov;13(11):1798-1802. doi: 10.1111/jdi.13884. Epub 2022 Jul 29. PMID: 35818819; PMCID: PMC9623521.
Freige C, McCormack S, Ford C. Islet Cell Transplantation for Patients with Unstable or Uncontrollable Diabetes Mellitus: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2020 Apr 29. PMID: 33119241.
Copyright (c) 2025 Aleksandra Kasprzyk, Klaudia Wilk, Edyta Witkowska, Marcin Ciechański, Szymon Cholewiński, Bernadetta Wilk, Piotr Stachura, Piotr Rejman, Katarzyna Pszczoła, Katarzyna Jurkiewicz
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