Islet Function and Dysfunction in Diabetes Mellitus and Transplantation

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Cellular Pathology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 2695

Special Issue Editor


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Guest Editor
1. Centre for Transplant and Renal Research, Westmead Institute for Medical Research, Westmead, NSW 2145, Australia
2. Renal and Transplant Unit, Westmead Hospital, Westmead, NSW 2145, Australia
3. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
Interests: kidney; acute kidney injury; chronic kidney disease; angiogenesis; signal transduction; dendritic cell biology; transplantation; islet biology

Special Issue Information

Dear Colleagues,

Diabetes mellitus is the third most common chronic condition experienced worldwide, after cancer and cardiovascular disease. Absent or defective insulin secretion are pathological features of type 1 and type 2 diabetes mellitus (DM). The immunological destruction of islets is a pathognomonic feature of type 1 DM, and is typically preceded by autoantibody production. Multiple endocrine pancreas abnormalities are seen in type 2 patients, ranging from changes in beta cell mass to exhaustion and loss. The manifestation of DM is often associated with altered genetic signaling.

Since the discovery and isolation of insulin in 1921, this has been the mainstay of diabetic treatment, although its exogenous administration cannot mimic normal metabolic control. Islet transplantation is a promising therapeutic option for type 1 diabetics. However, widespread application and long-term success is limited. The reality of the current transplant technique is challenging—more than 50% of islets are destroyed in the initial post-transplant period, multiple stress responses (hypoxia, inflammation, lack of angiogenesis) diminish islet function, and the immunosuppression required is itself diabetogenic.

This Special Issue will focus on derangements in islet cell biology in diabetes and following islet transplantation. 

Dr. Natasha M. Rogers
Guest Editor

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Keywords

  • type 1 diabetes mellitus
  • type 2 diabetes mellitus
  • islet transplantation
  • islet dysfunction
  • insulin

Published Papers (1 paper)

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Review

16 pages, 901 KiB  
Review
No Time to Die—How Islets Meet Their Demise in Transplantation
by Atharva Kale and Natasha M. Rogers
Cells 2023, 12(5), 796; https://doi.org/10.3390/cells12050796 - 3 Mar 2023
Cited by 5 | Viewed by 2319
Abstract
Islet transplantation represents an effective treatment for patients with type 1 diabetes mellitus (T1DM) and severe hypoglycaemia unawareness, capable of circumventing impaired counterregulatory pathways that no longer provide protection against low blood glucose levels. The additional beneficial effect of normalizing metabolic glycaemic control [...] Read more.
Islet transplantation represents an effective treatment for patients with type 1 diabetes mellitus (T1DM) and severe hypoglycaemia unawareness, capable of circumventing impaired counterregulatory pathways that no longer provide protection against low blood glucose levels. The additional beneficial effect of normalizing metabolic glycaemic control is the minimisation of further complications related to T1DM and insulin administration. However, patients require allogeneic islets from up to three donors, and the long-term insulin independence is inferior to that achieved with solid organ (whole pancreas) transplantation. This is likely due to the fragility of islets caused by the isolation process, innate immune responses following portal infusion, auto- and allo-immune-mediated destruction and β-cell exhaustion following transplantation. This review covers the specific challenges related to islet vulnerability and dysfunction that affect long-term cell survival following transplantation. Full article
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