Autologous pancreatic islet transplantation in human bone marrow
Paola Maffi, Gianpaolo Balzano, Maurilio Ponzoni, Rita Nano, Valeria Sordi, Raffaella Melzi, Alessia Mercalli, Marina Scavini, Antonio Esposito, Jacopo Peccatori, Elisa Cantarelli, Carlo Messina, Massimo Bernardi, Alessandro Del Maschio, Carlo Staudacher, Claudio Doglioni, Fabio Ciceri, Antonio Secchi, Lorenzo Piemonti, Paola Maffi, Gianpaolo Balzano, Maurilio Ponzoni, Rita Nano, Valeria Sordi, Raffaella Melzi, Alessia Mercalli, Marina Scavini, Antonio Esposito, Jacopo Peccatori, Elisa Cantarelli, Carlo Messina, Massimo Bernardi, Alessandro Del Maschio, Carlo Staudacher, Claudio Doglioni, Fabio Ciceri, Antonio Secchi, Lorenzo Piemonti
Abstract
The liver is the current site of choice for pancreatic islet transplantation, even though it is far from being ideal. We recently have shown in mice that the bone marrow (BM) may be a valid alternative to the liver, and here we report a pilot study to test feasibility and safety of BM as a site for islet transplantation in humans. Four patients who developed diabetes after total pancreatectomy were candidates for the autologous transplantation of pancreatic islet. Because the patients had contraindications for intraportal infusion, islets were infused in the BM. In all recipients, islets engrafted successfully as shown by measurable posttransplantation C-peptide levels and histopathological evidence of insulin-producing cells or molecular markers of endocrine tissue in BM biopsy samples analyzed during follow-up. Thus far, we have recorded no adverse events related to the infusion procedure or the presence of islets in the BM. Islet function was sustained for the maximum follow-up of 944 days. The encouraging results of this pilot study provide new perspectives in identifying alternative sites for islet infusion in patients with type 1 diabetes. Moreover, this is the first unequivocal example of successful engraftment of endocrine tissue in the BM in humans.
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References
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Source: PubMed