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Oct. 20th Seminar - Jonathan RT Lakey

Update on Status of Islet Transplantation

for the Treatment of Type 1 Diabetes

Jonathan RT Lakey, PhD, MSM

Associate Professor
Director of Surgical Research
Diretor of Clinical Islet Program
Department of Surgery University of California,Irvine

With close to 300 million people in the world suffering with diabetes and the diabetes incidence rate increasing, the need for better treatment options becomes more pressing. Currently, the standard treatment for Type 1 diabetes is insulin therapy, in which diabetic patients inject themselves with insulin in response to self-monitoring of blood glucose. While insulin therapy is life-saving for Type 1 diabetics, insulin therapy increases the risk of hypoglycemia and cannot prevent the secondary complications of Type 1 diabetes. Another potential treatment option is islet transplantation, in which insulin-producing cells are transplanted into diabetic patients along with other endocrine cells in the islets of Langerhans. Studies from the University of Alberta demonstrated the potential of islet transplantation with islets isolated from human cadaveric donors with patients experiencing periods of insulin independence following intraportal islet transplantation. These studies paved the way for others to replicate the “Edmonton Protocol” and also to advance methods of human islet isolation, immunosuppression protocols and improve post transplant care. 
There are two main issues with clinical islet transplantation. The first, donor organ scarcity, may be resolved with xenotransplantation. Specifically, most xenotransplantation experiments use of porcine islets in hopes of overcoming the lack of quality human cadaver pancreases. Another potential solution is the use of various stem cells, such as embryonic, mesenchymal, and induced pluripotent stem cells, to create insulin-producing cells. 
The second hurdle is the use of strong, life-long immunosuppressants that reduce quality of life for diabetic patients who have undergone islet transplantations. In response to the adverse effects of immunosuppressants, some studies and clinical trials are focusing on encapsulation of the islets into biomaterials including alginate capsules, in which biocompatible capsules protect the implanted islets from immunological destruction. 
The lecture will aim to provide a summary of the current state of islet transplantation by addressing xenotransplantation, the use of stem cells, and the use of biomaterials in the field of islet transplantation.
·International Trial of the Edmonton Protocol for islet transplantation. New England J Medicine. 355(13) 1318-1330, 2006 
·Beta-cell differentiation from nonendocrine epithelial cells of the adult human pancreas. Nature Medicine 12(3):310-6. 2006 
·Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. New England J. of Medicine 343:230-238, 2000 
·A human B-cell line for transplantation therapy to control type 1 diabetes. Nature Biotechnology 23(10):1274-1282, 2005 
·Noninvasive evaluation of the vascular response to transplantation of alginate encapsulated islets using the dorsal skin-fold model, Biomaterials, 35(3):891-8, 2014

Time: Oct. 20th, 2015, 14:30
Venue: New Biology Building, Room 143
Host: Prof. Yanan Du

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