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Islet Encapsulation: Physiological Possibilities and Limitations
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.ORCID iD: 0000-0002-8524-9547
2017 (English)In: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 66, no 7, p. 1748-1754Article in journal (Refereed) Published
Abstract [en]

A logical cure for type 1 diabetes (T1D) involves replacing the lost insulin-producing cells with new ones, preferably cells from a well-characterized and unlimited source of human insulin-producing cells. This straightforward and simple solution to provide a cure for T1D is immensely attractive but entails at least two inherent and thus far unresolved hurdles: 1) provision of an unlimited source of functional human insulin-producing cells and 2) prevention of rejection without the side effects of systemic immunosuppression. Generation of transplantable insulin-producing cells from human embryonic stem cells or induced pluripotent stem cells is at present close to reality, and we are currently awaiting the first clinical studies. Focus is now directed to foster development of novel means to control the immune system to enable large-scale clinical application. Encapsulation introduces a physical barrier that prevents access of immune cells to the transplanted cells but also hinders blood vessel ingrowth. Therefore, oxygen, nutrient, and hormonal passage over the encapsulation membrane is solely dependent on diffusion over the immune barrier, contributing to delays in glucose sensing and insulin secretion kinetics. This Perspective focuses on the physiological possibilities and limitations of an encapsulation strategy to establish near-normoglycemia in subjects with T1D, assuming that glucose-responsive insulin-producing cells are available for transplantation.

Place, publisher, year, edition, pages
AMER DIABETES ASSOC , 2017. Vol. 66, no 7, p. 1748-1754
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-328989DOI: 10.2337/db17-0065ISI: 000403778600003PubMedID: 28637827OAI: oai:DiVA.org:uu-328989DiVA, id: diva2:1139580
Funder
Swedish Research Council, K2015-54X-12219-19-4, 921-2014-7054Novo NordiskSwedish Child Diabetes FoundationSwedish Diabetes AssociationAvailable from: 2017-09-08 Created: 2017-09-08 Last updated: 2017-09-08Bibliographically approved

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Korsgren, Olle

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