Bioartificial Pancreas: In the Road to Clinical Application
With the increasing incidence of diabetes, it is urgent to develop a reliable and safe source of insulin production. Conventional transplantation of pancreatic tissue has been demonstrated to be an efficacious method of restoring glycaemic control in type
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Abstract With the increasing incidence of diabetes, it is urgent to develop a reliable and safe source of insulin production. Conventional transplantation of pancreatic tissue has been demonstrated to be an efficacious method of restoring glycaemic control in type 1 diabetes. However, the lack of donors, the use of immunosuppressants and the early “-cell failure limit the use of this approach. Regenerative medicine has focused on the design and application of bioartificial pancreas to treat this disease. Islet microencapsulation technique enables the transplantation in the absence of immunosuppression by protecting the cells through an immunoisolative membrane. This membrane should be able to protect transplanted allo- and xenogenic cells from the host, while facilitating adequate transport of oxygen, nutrients, and secreted hormones. Although many different materials and
J. Crisóstomo () Laboratory of Physiology, Institute of Biomedical Research in Light and Image, Faculty of Medicine of University of Coimbra, Sub-unit 1, 1st floor, Azinhaga de Santa Comba, Celas, 3060-350 Coimbra, Portugal Research Centre for Chemical Processes Engineering and Forest Products, Chemical Engineering Department, Faculty of Sciences and Technology of University of Coimbra, Polo II – Rua Sílvio Lima, 3030-790 Coimbra, Portugal e-mail: [email protected] J.F.J. Coelho Department of Chemical Engineering, University of Coimbra, Polo II, Pinhal de Marrocos 3030-790, Coimbra, Portugal e-mail: [email protected] R. Seiça Laboratory of Physiology, Institute of Biomedical Research in Light and Image, Faculty of Medicine of University of Coimbra, Sub-unit 1, 1st floor, Azinhaga de Santa Comba, Celas, 3060-350 Coimbra, Portugal e-mail: [email protected] J. Coelho (ed.), Drug Delivery Systems: Advanced Technologies Potentially Applicable in Personalised Treatment, Advances in Predictive, Preventive and Personalised Medicine 4, DOI 10.1007/978-94-007-6010-3__5, © Springer ScienceCBusiness Media Dordrecht 2013
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immunoisolation devices build-up processes have been studied, their viability in in vivo applications has been compromised. With clarification of all obstacles to the clinical application, new strategies will be developed that would increase the islet performance after transplantation. Keywords Diabetes treatment • Bioartificial pancreas • Islets encapsulation • Personalized medicine
1 The Target Disease: Diabetes Diabetes mellitus is a metabolic disease characterized by an abnormal increase in blood glucose levels. The high glucose concentration can result from the body incapacity to produce insulin (“-cell dysfunction/failure/mass reduction) and from the cells inability to respond to the produced insulin (peripheral and hepatic insulin resistance) [1] (Fig. 1). Chronic hyperglycemia, through several pathways, leads to the development of diabetes associated complications, such as diabetic neuropathy, retinopathy, nephropathy and cardiovascular disease, which are related to high rates of morbidity a
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