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Safley SA, Kenyon NS, Berman DM, Barber GF, Cui H, Duncanson S, De Toni T, Willman M, De Vos P, Tomei AA, Sambanis A, Kenyon NM, Ricordi C, Weber CJ. Microencapsulated islet allografts in diabetic NOD mice and nonhuman primates. Eur Rev Med Pharmacol Sci 2020; 24:8551-8565. [PMID: 32894560 DOI: 10.26355/eurrev_202008_22651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Our goal was to assess the efficacy of encapsulated allogeneic islets transplanted in diabetic NOD mice and streptozotocin (STZ)-diabetic nonhuman primates (NHPs). MATERIALS AND METHODS Murine or NHP islets were microencapsulated and transplanted in non-immunosuppressed mice or NHPs given clinically-acceptable immunosuppressive regimens, respectively. Two NHPs were treated with autologous mesenchymal stem cells (MSCs) and peri-transplant oxygen therapy. Different transplant sites (intraperitoneal [i.p.], omental pouch, omental surface, and bursa omentalis) were tested in separate NHPs. Graft function was monitored by exogenous insulin requirements, fasting blood glucose levels, glucose tolerance tests, percent hemoglobin A1c (% HbA1c), and C-peptide levels. In vitro assessment of grafts included histology, immunohistochemistry, and viability staining; host immune responses were characterized by flow cytometry and cytokine/chemokine multiplex ELISAS. RESULTS Microencapsulated islet allografts functioned long-term i.p. in diabetic NOD mice without immunosuppression, but for a relatively short time in immunosuppressed NHPs. In the NHPs, encapsulated allo-islets initially reduced hyperglycemia, decreased exogenous insulin requirements, elevated C-peptide levels, and lowered % HbA1c in plasma, but graft function diminished with time, regardless of transplant site. At necropsy, microcapsules were intact and non-fibrotic, but many islets exhibited volume loss, central necrosis and endogenous markers of hypoxia. Animals receiving supplemental oxygen and autologous MSCs showed improved graft function for a longer post-transplant period. In diabetic NHPs and mice, cell-free microcapsules did not elicit a fibrotic response. CONCLUSIONS The evidence suggested that hypoxia was a major factor for damage to encapsulated islets in vivo. To achieve long-term function, new approaches must be developed to increase the oxygen supply to microencapsulated islets and/or identify donor insulin-secreting cells which can tolerate hypoxia.
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Affiliation(s)
- S A Safley
- Department of Surgery, Emory University, Atlanta, GA, USA.
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Stabler CL, Giraldo JA, Berman DM, Gattás-Asfura KM, Willman MA, Rabassa A, Geary J, Diaz W, Kenyon NM, Kenyon NS. Transplantation of PEGylated islets enhances therapeutic efficacy in a diabetic nonhuman primate model. Am J Transplant 2020; 20:689-700. [PMID: 31597005 PMCID: PMC7042048 DOI: 10.1111/ajt.15643] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/19/2019] [Accepted: 09/29/2019] [Indexed: 01/25/2023]
Abstract
Islet cell transplantation can lead to insulin independence, reduced hypoglycemia, and amelioration of diabetes complications in patients with type 1 diabetes. The systemic delivery of anti-inflammatory agents, while considered crucial to limit the early loss of islets associated with intrahepatic infusion, increases the burden of immunosuppression. In an effort to decrease the pharmaceutical load to the patient, we modified the pancreatic islet surface with long-chain poly(ethylene glycol) (PEG) to mitigate detrimental host-implant interactions. The effect of PEGylation on islet engraftment and long-term survival was examined in a robust nonhuman primate model via three paired transplants of dosages 4300, 8300, and 10 000 islet equivalents per kg body weight. A reduced immunosuppressive regimen of anti-thymocyte globulin induction plus tacrolimus in the first posttransplant month followed by maintenance with sirolimus monotherapy was employed. To limit transplant variability, two of the three pairs were closely MHC-matched recipients and received MHC-disparate PEGylated or untreated islets isolated from the same donors. Recipients of PEGylated islets exhibited significantly improved early c-peptide levels, reduced exogenous insulin requirements, and superior glycemic control, as compared to recipients of untreated islets. These results indicate that this simple islet modification procedure may improve islet engraftment and survival in the setting of reduced immunosuppression.
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Affiliation(s)
- CL Stabler
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL USA,Diabetes Research Institute, University of Miami, Miami, FL USA,Corresponding Authors: Prof Cherie Stabler, ; Prof Norma Kenyon,
| | - JA Giraldo
- Diabetes Research Institute, University of Miami, Miami, FL USA
| | - DM Berman
- Diabetes Research Institute, University of Miami, Miami, FL USA,Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136
| | - KM Gattás-Asfura
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL USA,Diabetes Research Institute, University of Miami, Miami, FL USA
| | - MA Willman
- Diabetes Research Institute, University of Miami, Miami, FL USA
| | - A Rabassa
- Diabetes Research Institute, University of Miami, Miami, FL USA
| | - J Geary
- Diabetes Research Institute, University of Miami, Miami, FL USA
| | - W Diaz
- Diabetes Research Institute, University of Miami, Miami, FL USA
| | - NM Kenyon
- Diabetes Research Institute, University of Miami, Miami, FL USA
| | - NS Kenyon
- Diabetes Research Institute, University of Miami, Miami, FL USA,Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136,Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, FL 33136,Biomedical Engineering, University of Miami, Miami, FL 33136,Corresponding Authors: Prof Cherie Stabler, ; Prof Norma Kenyon,
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Perez VL, Caicedo A, Berman DM, Arrieta E, Abdulreda MH, Rodriguez-Diaz R, Pileggi A, Hernandez E, Dubovy SR, Parel JM, Ricordi C, Kenyon NM, Kenyon NS, Berggren PO. The anterior chamber of the eye as a clinical transplantation site for the treatment of diabetes: a study in a baboon model of diabetes. Diabetologia 2011; 54:1121-6. [PMID: 21360190 PMCID: PMC3247302 DOI: 10.1007/s00125-011-2091-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 01/19/2011] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to provide evidence that the anterior chamber of the eye serves as a novel clinical islet implantation site. METHODS In a preclinical model, allogeneic pancreatic islets were transplanted into the anterior chamber of the eye of a baboon model for diabetes, and metabolic and ophthalmological outcomes were assessed. RESULTS Islets readily engrafted on the iris and there was a decrease in exogenous insulin requirements due to insulin secretion from the intraocular grafts. No major adverse effects on eye structure and function could be observed during the transplantation period. CONCLUSIONS/INTERPRETATION Our study demonstrates the long-term survival and function of allogeneic islets after transplantation into the anterior chamber of the eye. The safety and simplicity of this procedure provides support for further studies aimed at translating this technology into the clinic.
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Affiliation(s)
- V. L. Perez
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - A. Caicedo
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - D. M. Berman
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - E. Arrieta
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - M. H. Abdulreda
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - R. Rodriguez-Diaz
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - A. Pileggi
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - E. Hernandez
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - S. R. Dubovy
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J. M. Parel
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - C. Ricordi
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- The Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, 17177, Stockholm, Sweden
| | - N. M. Kenyon
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - N. S. Kenyon
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - P. O. Berggren
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- The Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, 17177, Stockholm, Sweden
- Division of Integrative Biosciences and Biotechnology, WCU Program, Pohang University of Science and Technology, Pohang, South Korea
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