Calcium phosphate cement chamber as an immunoisolative device for bioartificial pancreas: in vitro and preliminary in vivo study

The Role of the Pancreatic Extracellular Matrix as a Tissue Engineering Support for the Bioartificial Pancreas

Type 1 diabetes mellitus (T1DM) is a chronic condition primarily managed with insulin replacement, leading to significant treatment costs. Complications include vasculopathy, cardiovascular diseases, nephropathy, neuropathy, and reticulopathy. Pancreatic islet transplantation is an option but its success does not depend solely on adequate vascularization. The main limitations to clinical islet transplantation are the scarcity of human pancreas, the need for immunosuppression, and the inadequacy of the islet isolation process. Despite extensive research, T1DM remains a major global health issue. In 2015, diabetes affected approximately 415 million people, with projected expenditures of USD 1.7 trillion by 2030. Pancreas transplantation faces challenges due to limited organ availability and complex vascularization. T1DM is caused by the autoimmune destruction of insulin-producing pancreatic cells. Advances in biomaterials, particularly the extracellular matrix (ECM), show promise in tissue reconstruction and transplantation, offering structural and regulatory functions critical for cell migration, differentiation, and adhesion. Tissue engineering aims to create bioartificial pancreases integrating insulin-producing cells and suitable frameworks. This involves decellularization and recellularization techniques to develop biological scaffolds. The challenges include replicating the pancreas's intricate architecture and maintaining cell viability and functionality. Emerging technologies, such as 3D printing and advanced biomaterials, have shown potential in constructing bioartificial organs. ECM components, including collagens and glycoproteins, play essential roles in cell adhesion, migration, and differentiation. Clinical applications focus on developing functional scaffolds for transplantation, with ongoing research addressing immunological responses and long-term efficacy. Pancreatic bioengineering represents a promising avenue for T1DM treatment, requiring further research to ensure successful implementation.

Insulin-loaded hydroxyapatite combined with macrophage activity to deliver insulin for diabetes mellitus

InsHAP is engulfed by macrophages and the lysosome/endosome hybrid is broken down by osmosis, which facilitates delivery of insulin into the bloodstream.

Comparison of bioartificial pancreas performance in the bone marrow cavity and intramuscular space

BACKGROUND AND AIMS

Bone marrow with a widely distributed and well-vascularized microenvironment that is capable of sustaining grafts is a potential site for islet transplantation. The femur bone marrow cavity offers sufficient space that may also receive the implantation of bioartificial pancreas (BAP).

METHODS

Mouse insulinoma cells encapsulating in agarose gel were further enclosed in a calcium phosphate cement chamber to create a BAP. BAPs implanted into the femur bone marrow cavity of diabetics were compared with those implanted in the intramuscular space. Blood glucose level and C-peptide were determined perioperatively.

RESULTS

The blood glucose level of the diabetics receiving BAPs in the intramuscular space decreased from 413 +/- 24 to 285 +/- 47 mg/dL at 1 day post-surgery. However, the blood glucose level returned to 398 +/- 35 mg/dL with undetectable serum C-peptide at 2 weeks postoperatively that reveals implant failure. The blood glucose level of diabetics receiving BAPs into the femur bone marrow cavity decreased from 422 +/- 32 to 247 +/- 52 mg/dL and maintained in the range of 288 +/- 47 mg/dL during the experimental period with an increase in C-peptide level from 6.1 +/- 2.8 to 104.7 +/- 16.4 pmol/L.

CONCLUSIONS

This preliminary study indicates that the effectiveness of BAPs transplanted into the femur bone marrow cavity is superior to that implanted in the intramuscular space, which reveals the bone marrow may be a potential receptor site for the BAP transplantation.

Enhancing clinical islet transplantation through tissue engineering strategies

Clinical islet transplantation (CIT), the infusion of allogeneic islets within the liver, has the potential to provide precise and sustainable control of blood glucose levels for the treatment of type 1 diabetes. The success and long-term outcomes of CIT, however, are limited by obstacles such as a nonoptimal transplantation site and severe inflammatory and immunological responses to the transplant. Tissue engineering strategies are poised to combat these challenges. In this review, emerging methods for engineering an optimal islet transplantation site, as well as novel approaches for improving islet cell encapsulation, are discussed.