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Immunomodulation & island-cell transplantation: Diabetes cured in 7 years?
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Diabetes mellitus is a beta-cell disease
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Immunomodulation - diabetes cured in 7 years?
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Prevention
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Prevention
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Rationale for late intervention: preservation of residual beta-cell function
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Sustainded beta-cell function is associated with a reduced rate of new-onset albuminuria or worsening of retinopathy
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Potential late interventions for preservation of beta-cell mass
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Targeting islet inflammation in de novo type 1 diabetes for β-cell preservation
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Prevention
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Islet transplantation - diabetes cured in 7 years?
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Curing diabetes! Pancreas transplantation
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Regression of coronary atherosclerosis after pancreas transplantation
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Benefit of SPK over LDK transplantation in recipients with type 1 diabetes
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Islet transplantation – since 2007 in the Netherlands (LUMC) (5-10/year)
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Islet isolation procedure
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Transplantation outcome
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Clinical benefit: chronic diabetic complications
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Clinical benefit in islet-after kidney: improved kidney graft survival
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Current options for beta-cell therapy in the LUMC
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Shortage of organ donors NL 256 (2011)
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Evidence for islet neogenesis from the duct epithelium in human adults
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Isolation of human duct cells after islet isolation
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Intact ducti develop “organoids” in matrigel
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In vivo differentiation: organoid transplantation under the kidney capsule
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Organoids under the kidney capsule differentiate to
insulin producing cells
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