Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Shanghai Institute for Plastic and Reconstructive Surgery, China.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China; Shanghai Institute for Plastic and Reconstructive Surgery, China; Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, China.
Metabolism. 2024 Mar;152:155786. doi: 10.1016/j.metabol.2024.155786. Epub 2024 Jan 10.
Diabetes presents a pressing healthcare crisis, necessitating innovative solutions. Organoid technologies have rapidly advanced, leading to the emergence of bioengineering islet organoids as an unlimited source of insulin-producing cells for treating insulin-dependent diabetes. This advancement surpasses the need for cadaveric islet transplantation. However, clinical translation of this approach faces two major limitations: immature endocrine function and the absence of a perfusable vasculature compared to primary human islets. In this review, we summarize the latest developments in bioengineering functional islet organoids in vitro and promoting vascularization of organoid grafts before and after transplantation. We highlight the crucial roles of the vasculature in ensuring long-term survival, maturation, and functionality of islet organoids. Additionally, we discuss key considerations that must be addressed before clinical translation of islet organoid-based therapy, including functional immaturity, undesired heterogeneity, and potential tumorigenic risks.
糖尿病带来了紧迫的医疗保健危机，需要创新的解决方案。类器官技术迅速发展，导致生物工程胰岛类器官作为治疗胰岛素依赖型糖尿病的胰岛素产生细胞的无限来源的出现。这一进展超越了对尸体胰岛移植的需求。然而，这种方法的临床转化面临两个主要限制：与原代人胰岛相比，内分泌功能不成熟，以及缺乏可灌注的脉管系统。在这篇综述中，我们总结了体外生物工程功能性胰岛类器官的最新进展，以及移植前后促进类器官移植物血管生成的最新进展。我们强调了脉管系统在确保胰岛类器官的长期存活、成熟和功能方面的关键作用。此外，我们讨论了在基于胰岛类器官的治疗进行临床转化之前必须解决的关键问题，包括功能不成熟、不理想的异质性和潜在的致瘤风险。
