Abstract
Recently, there have been remarkable advances in the area of islet tissue isolation and immuno-alteration that place islet tissue transplantation on the verge of clinical trials. This paper reviews the islet isolation advances by focusing on 5 approaches: altering the pancreas in vivo, distending and/or perfusing the pancreas in vitro, chopping the pan-creas, isolating either intact islets or islet cells, and purifying the islet tissue. This review also focuses on 3 areas of islet tissue transplantation: islet tissue preparation, transplantation sites, and the prevention of rejection. Advances in these areas should solve the remaining technical problems currently preventing clinical trials.
Résumé
Des étapes considérables ont été franchies récemment dans le domaine de l'isolement des îlots pancréatiques et de leur immuno-altération, ce qui permet d'envisager à brève échéance des essais cliniques de greffes d'îlots. Cet article passe en revue les progrès des méthodes d'isolement, en se concentrant sur cinq modes d'approche. Il s'agit des méthodes pour modifier le pancréas in vivo, distendre et/ou perfuser le pancréas in vitro, le dissocier, isoler les îlots entiers ou les cellules d'îlots, et purifier le tissu insulaire. Nous examinons aussi trois des questions posées par la transplantation d'îlots, à savoir le choix du mode de préparation du tissu, la sélection du site de transplantation et l'évaluation des méthodes de prévention du rejet. Des progrès dans ces domaines devraient lever les derniers obstacles qui empêchent encore à ce jour les essais cliniques.
Resumen
Notorios avances han ocurrido recientemente en el área del transplante de tejido insular pancreático, específicamente en lo referente al aislamiento y purificación de suficiente cantidad de tejido insular humano y en lo relativo a la terapia inmunosupresiva, todo lo cual coloca al transplante de islotes al borde de la iniciación de ensayos clínicos. El presente trabajo revisa los avances logrados en el aislamiento de islotes a través de cinco enfoques diferentes, incluyendo métodos que alteran el páncreas in vivo, la distensión y/o perfusión del páncreas in vitro, la sección del páncreas en pequeños fragmentos, el aislamiento de islotes intactos o de células individuales y la purificación del tejido insular. Esta revisión también está enfocada sobre tres áreas del transplante de tejido insular: la definición de la preparación del tejido insular, la ubicación de los lugares de transplante y la evaluación de métodos de prevención del rechazo. Los avances que puedan ser logrados en estas áreas deberán resolver los problemas técnicos que todavía impiden realizar ensayos clínicos.
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Scharp, D.W. Isolation and transplantation of islet tissue. World J. Surg. 8, 143–151 (1984). https://doi.org/10.1007/BF01655129
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DOI: https://doi.org/10.1007/BF01655129