Enhancing Survival of Beta Cells for Successful Transplantation
Islet transplantation can replace insulin injections and provide more physiological glucose control, thus reducing complications and improving quality of life for individuals with type 1 diabetes. However, there are not sufficient donor islets available for all the individuals who need them, and often it takes islets from several donors to transplant one recipient, exacerbating the donor shortage. A major reason for the need for multiple donors is that more than 80% of transplanted islets die within the first week after transplantation. The surviving islets may overwork and gradually die from exhaustion. Although stem cell technology holds the promise of unlimited supply of islets in the future, stem cell-derived islets also have a low survival rate in the first few days after transplant. Islet death following transplant is caused by the lack of adequate oxygen and nutrient supplies during this period.
With the support of a philanthropic contribution from the Foundation for Diabetes Research, Association-funded researcher Qizhi Tang, PhD, at the University of California, San Francisco, is studying the changes induced in beta cells by the shortage of oxygen and nutrients. Evidence suggests that beta cells can be "trained" to survive oxygen and nutrient shortages that they are exposed to before and after transplantation.
The promise of an unlimited source of beta cells from stem cell technology is likely to become a reality in the next several years. However, how to use this new source of cells, how these cells live and function after transplantation, and how to best control immune responses against the transplanted tissue present additional barriers to the widespread use of islet transplant. Research in these areas will be essential for the realization of the potential of stem cell derived islets for the cure of diabetes.