A new medical approach could enable patients to live pain-free without complications of diabetes
Conventionally, severe chronic pancreatitis is treated by removing the pancreas. With this step, to preserve insulin responses, surgeons transplant islets to the liver, which has poor outcomes.
As an alternative, the new strategy from Northwestern University uses a synthetic gel to transplant islets to the omentum, showing promise in small and large animal studies. With the new approach, more islets survived transplantation and grew blood vessels into the omentum (the researchers transplanted islets to the omentum instead of the liver in order to bypass issues with clotting).
To develop the process, researchers have fabricated a new antioxidant biomaterial (citrate-based biomaterial platforms).
Prior to removing the pancreas from patients with severe, painful chronic pancreatitis, surgeons first harvest insulin-producing tissue clusters (islets). These are transplanted into the vasculature of the liver.
The objective of the transplant is to preserve a patient’s ability to control their own blood-glucose levels without insulin injections.
The process, however, destroys 50-80 percent of islets, and consequently one-third of patients become diabetic after surgery. Three years post-surgery, 70 percent of patients require insulin injections, accompanied by a list of side effects, including weight gain, hypoglycaemia and fatigue.
In an attempt to overcome this, the researchers transplanted islets from the pancreas to the omentum — the large, flat, fatty tissue that covers the intestines — instead of the liver. By secreting insulin in response to glucose, islets help the body maintain glycaemic control.
The aim was to create a healthier microenvironment for the islets. To achieve this, the researchers adhered the islets to the omentum with an inherently antioxidant and anti-inflammatory biomaterial. This material rapidly transforms from a liquid to a gel when exposed to body temperature.
In animal studies the gel successfully prevented oxidative stress and inflammatory reactions, significantly improving survival and preserving the function of transplanted islets. This marks the first time a synthetic antioxidant gel has been used to preserve function of transplanted islets.
The research appears in the journal Science Advances. The paper is titled “Phase-changing citrate macromolecule combats oxidative pancreatic islet damage, enables islet engraftment and function in the omentum.”