Subscribe to RSS
DOI: 10.1055/a-2734-1983
Extracellular Matrix-Guided Islet Cell Transplantation Results in Improved Glycemic Control in a NOD-SCID Mouse Model
Authors
Abstract
Current insulin therapy fails to fully restore physiological glucose homeostasis in type 1 diabetes mellitus, with 75% of patients unable to achieve the desired management targets. While stem cell-derived islets offer promising therapy, they require an enhanced extracellular matrix support for optimal transplantation outcomes. To address this challenge, we developed biofunctional endocrine micro-pancreata using decellularized porcine lung scaffolds seeded with embryonic stem cell-derived islets. In vivo efficacy was evaluated following subcutaneous or intraperitoneal transplantation into NOD-SCID mice, followed by streptozotocin induction of diabetes, with the comprehensive assessment of human insulin secretion, glucose homeostasis, and graft integration over 3 months. Our results demonstrated that endocrine micro-pancreata exhibited 1.4-fold-increased glucose-stimulated insulin secretion in vitro compared to non-responsive free islets. In vivo, endocrine micro-pancreas recipients maintained significantly lower glucose levels than controls throughout the experiment. Subcutaneous endocrine micro-pancreata showed superior performance, with 46% improved glucose tolerance versus 31% improvement for intraperitoneal delivery. Extensive CD31-positive neovascularization as well as insulin staining confirmed successful graft integration and sustained insulin production. Endocrine micro-pancreata provide a scalable platform for diabetes cell therapy, demonstrating sustained insulin secretion and improved glycemic control. The preserved extracellular matrix microenvironment supports islet function and vascularization, offering significant potential for clinical translation.
Publication History
Received: 08 September 2025
Accepted after revision: 28 October 2025
Article published online:
26 November 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
References
- 1 Hirsch IB, Juneja R, Beals JM. et al. The evolution of insulin and how it informs therapy and treatment choices. Endocr Rev 2020; 41: 733
- 2 Donnor T, Sarkar S. 2023 Insulin- pharmacology, therapeutic regimens and principles of intensive insulin therapy. Endotext 2023 [Accessed August 26, 2025]
- 3 Aronoff SL, Berkowitz K, Shreiner B, Want L. Glucose metabolism and regulation: beyond insulin and glucagon. Diabetes Spectrum 2004; 17: 183-190
- 4 Lee MH, Ward GM, MacIsaac RJ. et al. Mortality in people with Type 1 diabetes, severe hypoglycemia, and impaired awareness of hypoglycemia referred for islet transplantation. Transplant Direct 2018; 4: e401
- 5 Committee ADAPP, ElSayed NA, McCoy RG. et al 6. glycemic goals and hypoglycemia: standards of care in diabetes—2025. Diabetes Care 2025; 48 Supplement_1 S128-S145
- 6 Czech A. Long-term complications of diabetes mellitus. Farm Pol 1993; 49: 16-22
- 7 Ebekozien O, Mungmode A, Sanchez J. et al. Longitudinal trends in glycemic outcomes and technology use for over 48,000 people with type 1 diabetes (2016–2022) from the T1D exchange quality improvement collaborative. Diabetes Technol Ther 2023; 25: 765-773
- 8 Renard E, Ikegami H, Daher Vianna AG. et al. The SAGE study: Global observational analysis of glycaemic control, hypoglycaemia and diabetes management in T1DM. Diabetes Metab Res Rev 2021; 37: e3430
- 9 Chaudhary R, Khanna J, Rohilla M. et al. Investigation of pancreatic-beta cells role in the biological process of ageing. Endocr Metab Immune Disord Drug Targets 2023; 24: 348-362
- 10 Marfil-Garza BA, Imes S, Verhoeff K. et al. Pancreatic islet transplantation in type 1 diabetes: 20-year experience from a single-centre cohort in Canada. Lancet Diabetes Endocrinol 2022; 10: 519-532
- 11 Wang Q, Huang YX, Liu L. et al. Pancreatic islet transplantation: current advances and challenges. Front Immunol 2024; 15: 1391504
- 12 Mantovani M, da C, Gabanyi I, Pantanali CA. et al. Islet transplantation: overcoming the organ shortage. Diabetol Metab Syndr 2023; 15: 144
- 13 Sali S, Azzam L, Jaro T. et al. A perfect islet: reviewing recent protocol developments and proposing strategies for stem cell derived functional pancreatic islets. Stem Cell Res Ther 2025; 16: 160
- 14 Fujikura J, Anazawa T, Toyoda T. et al. Toward a cure for diabetes: iPSC and ESC-derived islet cell transplantation trials. J Diabetes Investig 2025; 16: 384-388
- 15 Reichman TW, Markmann JF, Odorico J. et al. Stem cell–derived, fully differentiated islets for type 1 diabetes. N Engl J Med 2025; 393: 858-868
- 16 Tremmel DM, Odorico JS. Rebuilding a better home for transplanted islets. Organogenesis 2018; 14: 163-168
- 17 Zhu D, Chen Z, Guo K. et al. Enhanced viability and functional maturity of iPSC-derived islet organoids by collagen-VI-enriched ECM scaffolds. Cell Stem Cell 2025; 32: 547-563.e7
- 18 Rezvani Ghomi E, Nourbakhsh N, Akbari Kenari M. et al. Collagen-based biomaterials for biomedical applications. J Biomed Mater Res B Appl Biomater 2021; 109 (12) 1986-1999
- 19 Zhou H, Li W, Pan L. et al. Human extracellular matrix (ECM)-like collagen and its bioactivity. Regen Biomater 2024; 11: rbae008
- 20 Smandri A, Al-Masawa ME, Hwei NM. et al. ECM-derived biomaterials for regulating tissue multicellularity and maturation. iScience 2024; 27: 109141
- 21 Pignatelli C, Campo F, Neroni A. et al. Bioengineering the vascularized endocrine pancreas: a fine-tuned interplay between vascularization, extracellular-matrix-based scaffold architecture, and insulin-producing cells. Transplant Int 2022; 35: 10555
- 22 Kumar N, Joisher H, Ganguly A. Polymeric Scaffolds for Pancreatic Tissue Engineering: A Review. Rev Diabet Stud 2018; 14: 334
- 23 Sionov RV, Finesilver G, Sapozhnikov L. et al. Beta cells secrete significant and regulated levels of insulin for long periods when seeded onto acellular micro-scaffolds. 2015; 21 (21/22) 2691-2702 https://home.liebertpub.com/tea
- 24 Begg DP, Woods SC. Interactions between the central nervous system and pancreatic islet secretions: a historical perspective. Adv Physiol Educ 2013; 37: 53-60
- 25 Li Y, Wu Q, Li L. et al. Decellularization of porcine whole lung to obtain a clinical-scale bioengineered scaffold. J Biomed Mater Res, Part A 2021; 109: 1623-1632
- 26 O’Neill JD, Anfang R, Anandappa A. et al. Decellularization of human and porcine lung tissues for pulmonary tissue engineering. Ann Thorac Surg 2013; 96: 1046-1056
- 27 Goldman O, Puchinsky D, Durlacher K. et al. Lung based engineered micro-pancreas sustains human beta cell survival and functionality. Horm Metab Res 2019; 51: 805-811
- 28 Molakandov K, Berti DA, Beck A. et al. Selection for CD26− and CD49A+ cells from pluripotent stem cells-derived islet-like clusters improves therapeutic activity in diabetic mice. Front Endocrinol (Lausanne) 2021; 12: 635405
- 29 Huang M, Joseph JW. Assessment of the metabolic pathways associated with glucose-stimulated biphasic insulin secretion. Endocrinology. 2014; 155: 1653-1666
- 30 Yang H, Wright JR. Human β cells are exceedingly resistant to streptozotocin in vivo. Endocrinology 2002; 143 (07) 2491-2495
- 31 Elsner M, Tiedge M, Lenzen S. Mechanism underlying resistance of human pancreatic beta cells against toxicity of streptozotocin and alloxan [5]. Diabetologia 2003; 46 (12) 1713-1714
- 32 De Vos A, Heimberg H, Quartier E. et al. Human and rat beta cells differ in glucose transporter but not in glucokinase gene expression. J Clin Invest 1995; 96 (05) 2489-2495
- 33 van Hengel EVA, van der Laan LJW, de Jonge J. et al. Towards safety and regulation criteria for clinical applications of decellularized organ-derived matrices. Bioengineering 2025; 12: 136
- 34 Crapo PM, Gilbert TW, Badylak SF. An overview of tissue and whole organ decellularization processes. Biomaterials 2011; 32: 3233-3243
- 35 Schmitz TC, Dede Eren A, Spierings J. et al. Solid-phase silica-based extraction leads to underestimation of residual DNA in decellularized tissues. Xenotransplantation 2021; 28: e12643 Epub 2020 Sep 15
- 36 Submission and Review of Sterility Information in Premarket Notification (510(k)) Submissions for Devices Labeled as Sterile | FDA. [Accessed August 26, 2025]
- 37 Denner J. Porcine endogenous retroviruses in xenotransplantation. Nephrol, Dial, Transplant 2024; 39: 1221-1227
- 38 Citro A, Ott HC. Can We Re-engineer the endocrine pancreas?. Curr Diab Rep 2018; 18: 122
- 39 Geng A, Yuan S, Yu QC. et al. The role of endothelial cells in pancreatic islet development, transplantation and culture. Front Cell Dev Biol 2025; 13: 1558137
