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Eisenson DL, Iwase H, Chen W, Hisadome Y, Cui W, Santillan MR, Schulick AC, Gu D, Maxwell A, Koenig K, Sun Z, Warren D, Yamada K. Combined islet and kidney xenotransplantation for diabetic nephropathy: an update in ongoing research for a clinically relevant application of porcine islet transplantation. Front Immunol 2024; 15:1351717. [PMID: 38476227 PMCID: PMC10927755 DOI: 10.3389/fimmu.2024.1351717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/08/2024] [Indexed: 03/14/2024] Open
Abstract
Combined islet and kidney xenotransplantation for the treatment of diabetic nephropathy represents a compelling and increasingly relevant therapeutic possibility for an ever-growing number of patients who would benefit from both durable renal replacement and cure of the underlying cause of their renal insufficiency: diabetes. Here we briefly review immune barriers to islet transplantation, highlight preclinical progress in the field, and summarize our experience with combined islet and kidney xenotransplantation, including both challenges with islet-kidney composite grafts as well as our recent success with sequential kidney followed by islet xenotransplantation in a pig-to-baboon model.
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Affiliation(s)
- Daniel L. Eisenson
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hayato Iwase
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Weili Chen
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yu Hisadome
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Wanxing Cui
- Cell Therapy and Manufacturing, Medstar Georgetown University Hospital, Washington DC, United States
| | - Michelle R. Santillan
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alexander C. Schulick
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Du Gu
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Amanda Maxwell
- Research Animal Resources, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kristy Koenig
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Zhaoli Sun
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Daniel Warren
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kazuhiko Yamada
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Xu B, Iwata H, Miyamoto M, Balamurugan AN, Murakami Y, Cui W, Imamura M, Inoue K. Functional Comparison of the Single-Layer Agarose Microbeads and the Developed Three-Layer Agarose Microbeads as the Bioartificial Pancreas: An In Vitro Study. Cell Transplant 2017. [DOI: 10.3727/000000001783986567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
In this study, the insulin secretory characteristics of the microencapsulated hamster islets were studied during long-term culture. The hamster islets were encapsulated as single-layer agarose microbeads or three-layer agarose microbeads with agarose and agarose containing poly(styrene sulfonic acid) (PSSa), respectively. The influence of PSSa on the function of the rat islets microencapsulted in three-layer microbeads was primarily monitored. The aim of this study was to examine the influence of the PSSa on the in vitro function of the islets encapsulated in the agarose/PSSa microbeads compared with single-layer agarose microbeads during long-term culture. The microbeads were cultured for 30 days in medium of Eagle's MEM at 37°C in 5% CO2 and 95% air. The basal insulin secretion into the culture medium was measured daily during the first 12 days and two times per week until 30 days. The microbeads were subjected to static incubation test on the 10th, 20th, and 30th day during culture. The basal insulin secretion level of the agarose/PSSa microbeads was significantly higher than that of single-layer agarose microbeads. The static incubation tests revealed a similar pattern of insulin secretion from both microbeads when they were exposed to high glucose challenge. In the static incubation test, both could significantly increase insulin release to more than 6.61 times (stimulation index) in response to high glucose stimulation and could significantly decrease when glucose concentration returned from high glucose to low glucose on the 10th, 20th, and 30th day of culture. This study demonstrated that the hamster islets enclosed in agarose/PSSa hydrogel not only continuously secreted basal amounts of insulin, but also maintained their response to high glucose stimulation similar to the agarose microbeads. The above results together with those of our previous in vivo study suggest that the three-layer microbeads (agarose/PSSa) are well suitable for xenotransplantation of islets for the clinical application.
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Affiliation(s)
- Baoyou Xu
- First Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, Japan
| | - Hiroo Iwata
- Institute for Frontier Medical Sciences, Kyoto University, Japan
| | - Masaaki Miyamoto
- Institute for Frontier Medical Sciences, Kyoto University, Japan
| | | | | | - Wanxing Cui
- First Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, Japan
| | - Masayuki Imamura
- First Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, Japan
| | - Kazutomo Inoue
- Institute for Frontier Medical Sciences, Kyoto University, Japan
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Hori H, Gu YJ, Nagata N, Balamurugan AN, Satake A, Morimoto Y, Wang WJ, Misawa Y, Nozawa Y, Nembai T, Miyamoto M, Nozawa M, Inoue K. Isolation, Culture, and Characterization of Endocrine Cells from 6-Month-Old Porcine Pancreas. Cell Transplant 2017. [DOI: 10.3727/000000001783986675] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Porcine endocrine cells were isolated from pancreas of 6-month-old pigs by two-step enzymatic digestion procedures. They were separated by the density gradient (isopycnic) centrifugation method using Histopaque-1077. Isolated cells were cultured and divided into two groups: suspension cells and adhesion cells. Suspension cells maintained their cell numbers on and after 7 days in culture. Approximately 1 107 cells were obtained from single pancreas of a 6-month-old pig. The cultured suspension cells took up dithizone (DTZ) staining 14 days after isolation in culture and indicated the presence of β-cells. In in vitro study, the suspension cells were capable of secreting insulin into the culture medium. The suspension cells were tested for insulin and glucagon staining by Western blot analysis. These results indicated the maintenance of endocrine cell function after isolation. However, cultured adhesion cells failed to maintain their function during culture. In in vivo study, the suspension cells were transplanted into diabetes-induced nude mice. Reduction in blood glucose level was obtained after transplantation. Intraperitoneal glucose tolerance test (IPGTT) results showed a normal pattern of blood glucose clearance. After 1 week, the transplanted endocrine cells were detected with anti-insulin antibody by immunostaining and it showed the presence of viable β-cells under the renal capsule of nude mice. Collectively, our results suggest that isolated and cultured suspension porcine endocrine cells maintained their endocrine function. These endocrine cells can be used as isolated islets for further study, including transplantation experiments.
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Affiliation(s)
- Hiroshi Hori
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Yuan Jun Gu
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Natsuki Nagata
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Appakaalai N. Balamurugan
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Akira Satake
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Yoshihiko Morimoto
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Wen Jing Wang
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Yuko Misawa
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
- Suzuka University of Medical Sciences, Mie, Japan
| | - Yuka Nozawa
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | | | - Masaaki Miyamoto
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Masumi Nozawa
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Kazutomo Inoue
- Department of Organ Reconstruction, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
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Poggioli R, Inverardi L, Ricordi C. Article Commentary: Islet Xenotransplantation. Cell Transplant 2017; 11:89-94. [DOI: 10.3727/096020198389816] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Raffaella Poggioli
- Diabetes Research Institute, University of Miami School of Medicine, 1450 NW 10th Ave., Miami, FL 33136
| | - Luca Inverardi
- Diabetes Research Institute, University of Miami School of Medicine, 1450 NW 10th Ave., Miami, FL 33136
| | - Camillo Ricordi
- Diabetes Research Institute, University of Miami School of Medicine, 1450 NW 10th Ave., Miami, FL 33136
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Tsuchiya M, Tsuchiya K, Ohgawara H. Molecular Cloning of the Porcine Insulin cDNA Using a Monolayer Culture of Pancreatic Endocrine Cells. Cell Transplant 2017. [DOI: 10.3727/000000001783986611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Porcine pancreatic endocrine cells are an attractive candidate for islet cell transplantation in view of the immunological properties and structural similarities of porcine insulin to human insulin. We recently established a method of isolation and a primary monolayer culture of porcine pancreatic endocrine cells. In this study, cloning of the porcine insulin cDNA was performed to clarify the genetic background of the purified isolated cells. A homology-based PCR cloning method was employed to determine the sequence using mRNA extracted from the monolayer-forming cells, and the candidate products were then determined by a homology search on the human insulin cDNA. According to the newly identified sequence, rapid amplification of cDNA ends was applied to the 5′ and 3′ ends, and the entire cDNA sequence was determined. Gene and protein expression was confirmed by Northern blotting, immunohistochemistry, and enzyme assay. To examine the transcriptional level, the cultured cells were incubated in a 20 mM D-glucose medium in the presence or absence of 5 μM forskolin. The porcine insulin cDNA exhibited a high homology to the human cDNA and showed 85% matching with the human amino acid sequence. D-Glucose at 20 mM stimulated the insulin secretion and mRNA expression, and further addition of 5 μM forskolin with the glucose was applied as the strongest stimulus in this culture system.
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Affiliation(s)
- Mariko Tsuchiya
- Institute of Geriatrics, Aoyama Hospital, Tokyo Women's Medical University, Tokyo, Japan
| | - Ken Tsuchiya
- Department of Medicine IV, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisako Ohgawara
- Medical Research Institute, Tokyo Women's Medical University, Tokyo, Japan
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Gazda LS, Adkins H, Bailie JA, Byrd W, Circle L, Conn B, Diehl CH, Hall RD, Rubin AL, Smith BH. The Use of Pancreas Biopsy Scoring Provides Reliable Porcine Islet Yields While Encapsulation Permits the Determination of Microbiological Safety. Cell Transplant 2017; 14:427-39. [PMID: 16285251 DOI: 10.3727/000000005783982846] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
For clinical xenogenic islet transplantation to be successful, several requirements must be met. Among them is a sizeable and reliable source of fully functional and microbiologically safe islets. The inherent variability among porcine pancreases, with respect to islet yield, prompted us to develop a Biopsy Score technique to determine the suitability of each pancreas for islet isolation processing. The Biopsy Score consists of an assessment of five variables: warm ischemia time, pancreas color, fat content, islet size, and islet demarcation, each of which is assigned a value of −1 or +1, depending on whether or not the established criteria is met. For determination of islet size and demarcation, fresh biopsies of porcine pancreases are stained with dithizone (DTZ) solution and examined under a dissecting microscope. Based on the scoring of such biopsies in pancreases from 26—56-month-old sows, we report here that the presence of large (>100 μm diameter), well-demarcated islets in the pancreas biopsy is a reliable predictor of isolation success. Encapsulation of the isolated porcine islets within the inner layer of a 1.5% agarose and an outer layer of 5.0% agarose macrobead, containing 500 equivalent islet number (EIN), provides for extended in vitro functional viability (>6 months of insulin production in response to glucose), as well as for comprehensive microbiological testing and at least partial isolation of the xenogeneic islets from the host immune system. All microbiological testing to date has been negative, except for the presence of porcine endogenous retrovirus (PERV). Taken together, we believe that the Biopsy Score enhancement of our islet isolation technique and our agarose-agarose macroencapsulation methodology bring us significantly closer to realizing clinical porcine islet xenotransplantation for the treatment of insulin-dependent diabetic patients.
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Monden M. Cell Therapy '98: An Introduction. Cell Transplant 2017. [DOI: 10.1177/096368979900800407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Morito Monden
- 6th Annual Meeting of the Society for Cell Therapy, Dept. of Surgery II, Osaka University Medical School
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Stiegler P, Stadlbauer V, Hackl F, Schaffellner S, Iberer F, Greilberger J, Strunk D, Zelzer S, Lackner C, Tscheliessnigg K. Prevention of oxidative stress in porcine islet isolation. J Artif Organs 2010; 13:38-47. [DOI: 10.1007/s10047-010-0488-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Accepted: 12/24/2009] [Indexed: 01/11/2023]
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Swanson CJ, Olack BJ, Goodnight D, Zhang L, Mohanakumar T. Improved methods for the isolation and purification of porcine islets. Hum Immunol 2001; 62:739-49. [PMID: 11423181 DOI: 10.1016/s0198-8859(01)00255-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Recent progress in human islet transplantation demonstrates the feasibility of using purified human islets for treatment of type 1 diabetes mellitus; however, a shortage of human pancreata remains a major obstacle. This report describes methods to isolate porcine islets using a modification of the automated chamber method. The pancreata from 2-year-old sows were trimmed and injected intraductally with Sevac, Sigma, or Liberase PI collagenase. The pancreata was placed in the chamber, shaken, and recirculated at 70 ml/min until an adequate number of islets were liberated. The digest was centrifuged and the pellets pooled with University of Wisconsin Solution + 10% horse serum and incubated at 4 degrees C for 1 h. The islets were purified using a continuous gradient of Hypaque Euroficoll on a refrigerated COBE 2991. The islets were collected in fractions, assessed for purity, sized, and then suspended in Medium 199. Collagenase preparations obtained from Sevac (2919 islet equivalents [IE]/g), Sigma (2543 IE/g), and Liberase PI (2901 IE/g) gave similar results with 94%-95% purity. In summary, we report a successful method for efficient isolation and purification of porcine islets, yielding nearly 3000 IE/gm, with different collagenase products.
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Affiliation(s)
- C J Swanson
- Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
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Kurup S, Risbud MV, Bhonde RR. Selective cytotoxicity of MIA Pa Ca-2 conditioned medium to acinar cells: a novel approach to reduce acinar cell contaminants in isolated islet preparations from BALB/c mice. Transpl Int 2001. [DOI: 10.1111/j.1432-2277.2001.tb00040.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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