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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 24, 2015; 5(1): 1-10
Published online Mar 24, 2015. doi: 10.5500/wjt.v5.i1.1
Bioengineered stem cells as an alternative for islet cell transplantation
Sarah J Moore, Boris L Gala-Lopez, Andrew R Pepper, Rena L Pawlick, AM James Shapiro
Sarah J Moore, Boris L Gala-Lopez, Andrew R Pepper, Rena L Pawlick, AM James Shapiro, Alberta Diabetes Institute, University of Alberta, Edmonton AB T6G 2E1, Canada
Sarah J Moore, AM James Shapiro, Clinical Islet Transplant Program, University of Alberta, Edmonton AB T6G 2C8, Canada
Author contributions: Moore SJ wrote the manuscript, with help from Gala-Lopez BL, Pepper AR, Pawlick RL and Shapiro AMJ, who expanded and proof-read all aspects of the paper.
Supported by The Collaborative Research and Innovation Opportunities (CRIO)-Alberta Innovates health Solutions; the Diabetes Research Institute Foundation of Canada (DRIFCan); the Canadian National Transplant Research Program (CNTRP); the Alberta Diabetes Institute (ADI); the Clinical Islet Transplant Program; Shapiro AMJ are supported through NIH Funding through the Collaborative Islet Transplant Consortium (CIT); Shapiro AMJ is further supported through a Canada Research Chair in Transplantation Surgery and Regenerative Medicine, and through Alberta Innovates Healthcare Solutions as a Senior Scholar.
Conflict-of-interest: AM James Shapiro serves as a consultant and collaborator with ViaCyte Inc., San Diego, and with Sernova Corp., London Ontario; there are no other relevant conflicts to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: AM James Shapiro, MD, PhD, FRCS (Eng), FRCSC, MSM, Fellow of the Royal Society of Canada, Canada Research Chair in Transplant Surgery and Regenerative Medicine, Professor of Surgery, Medicine and Surgical Oncology, Clinical Islet Transplant Program, University of Alberta, 2000 College Plaza, 8215 112th St, Edmonton AB T6G 2C8, Canada. amjs@islet.ca
Telephone: +1-780-4077330 Fax: +1-780-4078259
Received: August 20, 2014
Peer-review started: August 20, 2014
First decision: September 28, 2014
Revised: January 13, 2015
Accepted: January 30, 2015
Article in press: February 2, 2015
Published online: March 24, 2015
Processing time: 442 Days and 11.3 Hours
Abstract

Type 1 diabetes is an autoimmune and increasingly prevalent condition caused by immunological destruction of beta cells. Insulin remains the mainstay of therapy. Endeavours in islet transplantation have clearly demonstrated that type 1 diabetes is treatable by cellular replacement. Many challenges remain with this approach. The opportunity to use bioengineered embryonic or adult pluripotential stem cells, or islets derived from porcine xenograft sources could address future demands, but are still associated with considerable challenges. This detailed review outlines current progress in clinical islet transplantation, and places this in perspective for the remarkable scientific advances now occurring in stem cell and regenerative medicine approaches in the treatment of future curative treatment of diabetes.

Keywords: Islet transplantation; Hypoxia; Stem cell; Diabetes

Core tip: This paper gives a historical overview of the use of islet transplantation for the treatment of type 1 diabetes mellitus. Islet cell transplantation has seen enormous development over the years; however, this has not been without its limitations. The aim of this paper is to provide an overview of the feasibility of an alternative cell source for clinical islet transplantation.