Dresden International Graduate School for Interdisciplinary Life Sciences

Type 1 diabetes (T1D) is an autoimmune disease with increasing incidence over the last decades. Despite major advances in the treatment of T1D, it is still associated with substantial morbidities and a significant reduction in life expectancy. The transplantation of isolated pancreatic islets is an established therapy for a subset of patients with T1D that can effectively restore normoglycemia, prevent hypoglycemia and stabilize the long-term complications of T1D. However, several issues prohibit this therapy from becoming more wide-spread. First, there is a lack of suitable human donor organs. Second, human islet transplantation currently requires life-long immunosuppression, and third, the long-term effects of the graft are unsatisfying due to immunological and inflammatory reactions, which are also associated with the suboptimal microenvironmental features of the islet transplant.

Therefore, numerous research activities are currently addressing these issues in order to provide beta-cell replacement therapy to a broader cohort of patients with diabetes. The encapsulation of pancreatic islets may allow protection of the islet graft without the need for immunosuppressive agents and moreover expand the donor pool to animal tissue and novel insulin-producing cells. Despite major advances in encapsulation technology, there are still issues that need to be resolved primarily associated with immuno-protection, inflammatory responses, material biocompatibility, and transplantation site. The recent advances in xenotransplantation and particularly in the field of stem cell-derived beta-cells have generated a renewed scientific interest in encapsulation technology.

This presentation highlights the current state of technology and recent significant breakthroughs, as well as the unmet needs and roadblocks to xenotransplantation, and stem-cell-derived ß-cell therapies, with the aim of spurring innovative research conceptions, preclinical investigations and clinical vision.

Barbara Ludwig
University Hospital Carl Gustav Carus, Department of Medicine III, Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Faculty of Medicine of the TU Dresden, DFG-Center for Regenerative Therapies Dresden, Technische Universität Dresden, Germany; University Hospital Zurich, Department of Endocrinology and Diabetology, Zurich, Switzerland