Endocrinology and Metabolism

Original Article

Endocrine Research
Suppression of Fibrotic Reactions of Chitosan-Alginate Microcapsules Containing Porcine Islets by Dexamethasone Surface Coating: Min Jung Kim, Heon-Seok Park, Ji-Won Kim, Eun-Young Lee, Marie Rhee, Young-Hye You, Gilson Khang, Chung-Gyu Park, Kun-Ho Yoon; Endocrinol Metab. 2021;36(1):146-156. Published online February 24, 2021; DOI: https://doi.org/10.3803/EnM.2021.879

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Background
The microencapsulation is an ideal solution to overcome immune rejection without immunosuppressive treatment. Poor biocompatibility and small molecular antigens secreted from encapsulated islets induce fibrosis infiltration. Therefore, the aims of this study were to improve the biocompatibility of microcapsules by dexamethasone coating and to verify its effect after xenogeneic transplantation in a streptozotocin-induced diabetes mice.
Methods
Dexamethasone 21-phosphate (Dexa) was dissolved in 1% chitosan and was cross-linked with the alginate microcapsule surface. Insulin secretion and viability assays were performed 14 days after microencapsulation. Dexa-containing chitosan-coated alginate (Dexa-chitosan) or alginate microencapsulated porcine islets were transplanted into diabetic mice. The fibrosis infiltration score was calculated from the harvested microcapsules. The harvested microcapsules were stained with trichrome and for insulin and macrophages.
Results
No significant differences in glucose-stimulated insulin secretion and islet viability were noted among naked, alginate, and Dexa-chitosan microencapsulated islets. After transplantation of microencapsulated porcine islets, nonfasting blood glucose were normalized in both the Dexa-chitosan and alginate groups until 231 days. The average glucose after transplantation were lower in the Dexa-chitosan group than the alginate group. Pericapsular fibrosis and inflammatory cell infiltration of microcapsules were significantly reduced in Dexa-chitosan compared with alginate microcapsules. Dithizone and insulin were positive in Dexa-chitosan capsules. Although fibrosis and macrophage infiltration was noted on the surface, some alginate microcapsules were stained with insulin.
Conclusion
Dexa coating on microcapsules significantly suppressed the fibrotic reaction on the capsule surface after transplantation of xenogenic islets containing microcapsules without any harmful effects on the function and survival of the islets.

Citations

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Engineering superstable islets-laden chitosan microgels with carboxymethyl cellulose coating for long-term blood glucose regulation in vivo
Haofei Li, Weijun He, Qi Feng, Junlin Chen, Xinbin Xu, Chuhan Lv, Changchun Zhu, Hua Dong
Carbohydrate Polymers.2024; 323: 121425. CrossRef
Investigation of encapsulation of pancreatic beta cells and curcumin within alginate microcapsules
Zahra Hosseinzadeh, Iran Alemzadeh, Manouchehr Vossoughi
The Canadian Journal of Chemical Engineering.2024; 102(2): 561. CrossRef
Advancements in innate immune regulation strategies in islet transplantation
Kehang Duan, Jiao Liu, Jian Zhang, Tongjia Chu, Huan Liu, Fengxiang Lou, Ziyu Liu, Bing Gao, Shixiong Wei, Feng Wei
Frontiers in Immunology.2024;[Epub] CrossRef
A Case for Material Stiffness as a Design Parameter in Encapsulated Islet Transplantation
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Tissue Engineering Part B: Reviews.2023; 29(4): 334. CrossRef
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Journal of Diabetes Investigation.2022; 13(11): 1798. CrossRef
Modern pancreatic islet encapsulation technologies for the treatment of type 1 diabetes
P. S. Ermakova, E. I. Cherkasova, N. A. Lenshina, A. N. Konev, M. A. Batenkin, S. A. Chesnokov, D. M. Kuchin, E. V. Zagainova, V. E. Zagainov, A. V. Kashina
Russian Journal of Transplantology and Artificial Organs.2021; 23(4): 95. CrossRef

Review Article

Stepwise Approach to Problematic Hypoglycemia in Korea: Educational, Technological, and Transplant Interventions: Sang-Man Jin; Endocrinol Metab. 2017;32(2):190-194. Published online June 23, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.190

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34 Download
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Abstract PDF PubReader

Impaired awareness of hypoglycemia has been found to be prevalent in 20% to 40% of people with type 1 diabetes. If a similar prevalence exists in Koreans with type 1 diabetes, at a minimum, thousands of people with type 1 diabetes suffer at least one unpredicted episode of severe hypoglycemia per year in Korea. For patients with problematic hypoglycemia, an evidence-based stepwise approach was suggested in 2015. The first step is structured education regarding multiple daily injections of an insulin analog, and the second step is adding a technological intervention, such as continuous subcutaneous insulin infusion or real-time continuous glucose monitoring. The next step is a sensor-augmented pump, preferably with a low glucose suspension feature or very frequent contact, and the final step is islet or pancreas transplantation. In Korea, however, none of these treatments are reimbursed by the National Health Insurance, and thus have not been widely implemented. The low prevalence of type 1 diabetes means that Korean physicians are relatively unfamiliar with the new technologies in this field. Therefore, the roles of new technologies and pancreas or islet transplantation in the treatment of problematic hypoglycemia need to be defined in the current clinical setting of Korea.

Citations

Citations to this article as recorded by

Protective and risk factors of impaired awareness of hypoglycemia in patients with type 1 diabetes: a cross-sectional analysis of baseline data from the PR-IAH study
Naoki Sakane, Ken Kato, Sonyun Hata, Erika Nishimura, Rika Araki, Kunichi kouyama, Masako Hatao, Yuka Matoba, Yuichi Matsushita, Masayuki Domichi, Akiko Suganuma, Seiko Sakane, Takashi Murata, Fei Ling Wu
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
A 4-Week, Two-Center, Open-Label, Single-Arm Study to Evaluate the Safety and Efficacy of EOPatch in Well-Controlled Type 1 Diabetes Mellitus
Jiyun Park, Nammi Park, Sangjin Han, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Woo Je Lee, Jae Hyeon Kim
Diabetes & Metabolism Journal.2022; 46(6): 941. CrossRef
Impaired hypoglycemia awareness in diabetes: epidemiology, mechanisms and therapeutic approaches
Vadim V. Klimontov
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