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Utility of co-transplanting mesenchymal stem cells in islet transplantation

World Journal of Gastroenterology 2011年第47期17卷 5150-5155页

作者： Naoaki Sakata Masafumi Goto gumpei yoshimatsu Shinichi Egawa Michiaki Unno Division of Hepato-Biliary-Pancreatic Surgery Department of Surgery Tohoku University Graduate School of Medicine 1-1 Seiryo-machi Aoba-ku Sendai Miyagi 980-8574 Japan Division of Advanced Surgical Science and Technology Tohoku University Graduate School of Medicine 1-1 Seiryo-machi Aoba-ku Sendai Miyagi 980-8574 Japan New Industry Creation Hatchery Center Tohoku University Graduate School of Medicine 1-1 Seiryomachi Aoba-ku Sendai Miyagi 980-8574 Japan

Islet transplantation is characterized by the transplantation of isolated islets from donor pancreata into a diabetic recipient. Although it is a viable choice in the treatment of insulin dependent diabetes mellitus, most patients (approximately 90%) require insulin five years after transplantation. Recently, the co-transplantation of mesenchymal stem cells (MSCs) and islets in animal studies has revealed the effectiveness of MSCs co-transplantation for improving islet function. Themechanisms underlying the beneficial impact of MSCs include immunomodulation and the promotion of angiogenesis. In this review, we discuss MSCs and how they support improved graft survival and function.

关键词： Mesenchymal stem cell Islet transplanta-tion Bone marrow Immunomodulatory Regulatory Tcell Angiogenesis Vascular endothelial growth factor Diabetes mellitus

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Encapsulated islets transplantation: Past, present and future

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World Journal of Gastrointestinal Pathophysiology 2012年第1期3卷 19-26页

作者： Naoaki Sakata Shoichiro Sumi gumpei yoshimatsu Masafumi Goto Shinichi Egawa Michiaki Unno Division of Hepato-Biliary-Pancreatic Surgery Department of Surgery Tohoku University Graduate School of Medicine Sendai Miyagi 980-8574 Japan Department of Organ Reconstruction Field of Clinical Application Institute for Frontier Medical Sciences Kyoto University Kyoto 6068501 Japan Division of Advanced Surgical Science and Technology Tohoku University Graduate School of Medicine Sendai Miyagi 980-8574 Japan New Industry Creation Hatchery Center Tohoku University Graduate School of Medicine Sendai Miyagi 980-8574 Japan

Islet transplantation could become an ideal treatment for severe diabetes to prevent hypoglycemia shock and irreversible diabetic complications, once some of the major and unresolved obstacles are overcome, including limited donor supplies and side effects caused by permanent immunosuppressant use. Approximately 30 years ago, some groups succeeded in improving the blood glucose of diabetic animals by transplanting encapsulated islets with semi-permeable membranes consisting of polymer. A semi-permeable membrane protects both the inner islets from mechanical stress and the recipient’s immune system (both cellular and humoral immunities), while allowing bidirectional diffusion of nutrients, oxygen, glucose, hormones and wastes, i.e., immune-isolation. This device, which enables immune-isolation, is called encapsulated islets or bio-artificial pancreas. Encapsulation with a semipermeable membrane can provide some advantages: (1) this device protects transplanted cells from the recipient’s immunity even if the xenogeneic islets (from large animals such as pig) or insulin-producing cells are derived from cells that have the potential for differentiation (some kinds of stem cells). In other words, the encapsulation technique can resolve the problem of limited donor supplies; and (2) encapsulation can reduce or prevent chronic administration of immunosuppressants and, therefore, important side effects otherwise induced by immunosuppressants. And now, many novel encapsulated islet systems have been developed and are being prepared for testing in a clinical setting.

关键词： Islet transplantation Encapsulated islets Bio-artificial pancreas

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