The efficacy of an immunoisolating membrane system for islet xenotransplantation in minipigs

免疫隔离膜系统对小型猪胰岛异种移植的疗效

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作者:Tova Neufeld, Barbara Ludwig, Uriel Barkai, Gordon C Weir, Clark K Colton, Yoav Evron, Maria Balyura, Karina Yavriyants, Baruch Zimermann, Dmitri Azarov, Shiri Maimon, Noa Shabtay, Tania Rozenshtein, Dana Lorber, Anja Steffen, Udi Willenz, Konstantine Bloch, Pnina Vardi, Ran Taube, Paul de Vos, Eli

Abstract

Developing a device that protects xenogeneic islets to allow treatment and potentially cure of diabetes in large mammals has been a major challenge in the past decade. Using xenogeneic islets for transplantation is required in light of donor shortage and the large number of diabetic patients that qualify for islet transplantation. Until now, however, host immunoreactivity against the xenogeneic graft has been a major drawback for the use of porcine islets. Our study demonstrates the applicability of a novel immunoprotective membrane that allows successful xenotransplantation of rat islets in diabetic minipigs without immunosuppressive therapy. Rat pancreatic islets were encapsulated in highly purified alginate and integrated into a plastic macrochamber covered by a poly-membrane for subcutaneous transplantation. Diabetic Sinclair pigs were transplanted and followed for up to 90 days. We demonstrated a persistent graft function and restoration of normoglycemia without the need for immunosuppressive therapy. This concept could potentially offer an attractive strategy for a more widespread islet replacement therapy that would restore endogenous insulin secretion in diabetic patients without the need for immunosuppressive drugs and may even open up an avenue for safe utilization of xenogeneic islet donors.

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