Pancreatic islet transplantation is a promising treatment option for individuals with type 1 diabetes; however, maintaining islet function after transplantation remains a large challenge. Multiple factors, including hypoxia associated events, trigger pretransplant and posttransplant loss of islet function. In fact, islets are easily damaged in hypoxic conditions before transplantation including the preparation steps of pancreas procurement, islet isolation, and culture. Furthermore, after transplantation, islets are also exposed to the hypoxic environment of the transplant site until they are vascularized and engrafted. Because islets are exposed to such drastic environmental changes, protective measures are important to maintain islet viability and function. Many studies have demonstrated that the prevention of hypoxia contributes to maintaining islet quality. In this review, we summarize the latest oxygen-related islet physiology, including computational simulation. Furthermore, we review recent advances in oxygen-associated treatment options used as part of the transplant process, including up-to-date oxygen generating biomaterials as well as a classical oxygen inhalation therapy.
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From the Division of Developmental and Translational Diabetes and Endocrinology Research, Department of Diabetes and Metabolic Research, Beckman Research Institute of City of Hope, Duarte, CA.
Received for publication November 14, 2017; accepted February 28, 2018.
Address correspondence to: Hirotake Komatsu, MD, PhD, Division of Developmental and Translational Diabetes and Endocrinology Research, Department of Diabetes and Metabolic Research, Beckman Research Institute of City of Hope, 1500 E. Duarte Rd, Duarte, CA 91010 (e-mail: email@example.com).
This work was supported by a grant from the Nora Eccles Treadwell Foundation (Title of Grant: CURE OF DIABETES, Grant Period: July 1, 2012 to June 30, 2020, P.I.: Yoko Mullen, MD, PhD) and a City of Hope-California Institute of Technology Biomedical Research Grant (Title of Grant: Oxygen Transporter for Extrahepatic Site Islet Transplantation, Grant Period: August 1, 2015 to July 31, 2016, P.I.: Fouad Kandeel, MD, PhD, and Yu-Chong Tai, PhD).
The authors declare no conflict of interest.
H.K. wrote the manuscript; Y.M. critically reviewed and edited; and F.K. commented and approved the manuscript.