Islet transplantation, a therapy currently offered in the framework of research, is for people struggling with insulin-dependent type 1 diabetes.
Priority is given to those who have already received a kidney transplant and have severe complications despite optimized insulin therapy (frequent and / or asymptomatic hypoglycemia, alternating hypoglycemia and keto-acidosis, constant unstable blood glucose, progression of complications, etc.). Type 1 (also called "insulin-dependent") diabetes is a chronic metabolic disorder.
Due to the destruction of the insulin-secreting cells (beta cells), located in pancreatic structures called "islets of Langerhans", this disease is characterized, among other things, by a glycemic imbalance.
For more than 90 years, the only treatment available has consisted of injecting oneself with the missing insulin, whether through repeated injections or by means of a pump. Islet transplantation, on the other hand, gives us the opportunity to replace those non-functional beta cells with functional cells from a donor. The goal of islet transplantation is to improve the recipient's glycemic balance, hoping to improve their quality of life and protect them from possible diabetes-related complications. This is, however, done at the cost of an immunosuppressive (anti-rejection) therapy, potentially for life.
Find here the last advances in Beta cell replacement therapy for the treatment of type 1 diabetes : Paper in Lancet, 2019.
Human islet production
The isolation technique developed in our laboratory is based on the enzymatic dissociation of the pancreas followed by a purification of the islets, also termed "endocrine" tissue, by density gradient centrifugation.
A sufficient mass of endocrine tissue is one of the key factors in the success of an islet transplantation, but it is also one of the main difficulties encountered by and common to the twenty or so teams that currently perform the islet isolation procedure in the world. As the procedure concerns uncontrollable factors such as the clinical characteristics of the donor, the outcome is often unpredictable and insufficient in islet yield.
In practice, the combination of several preparations of several islet preparations remains essential in most cases in order to transplant a sufficient amount of endocrine tissue.