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Hundreds of millions of people worldwide suffer from diabetes. There are some 800,000 diabetics in the Netherlands alone. In a healthy body, the hormone insulin (which regulates blood sugar levels) is produced by clusters of endocrine cells in the regions of the pancreas known as the ‘islets of Langerhans’. In people with Type 1 diabetes, the cells in the islets are selectively destroyed by an autoimmune process, resulting in a an insulin deficiency. Insulin can be injected directly into the bloodstream, but doing so increases the risk of heart or kidney failure. The Tissue Regeneration department at MIRA, University of Twente’s Institute for Biomedical Technology and Technical Medicine, is working on a new transplantation method which will solve this problem.

A 'mega-project'
A budget of eleven million euros has been reserved for this long-term research project, in which University of Twente will work alongside partners such as Leiden University Medical Centre. It is already possible to transplant islets of Langerhans into a patient but the results are far from satisfactory. Many of the transplanted islets die within a few days due to poor blood flow and oxygen starvation. Most patients must therefore undergo two or three transplant operations, which is clearly expensive and distressing. Moreover, the supply of donor organs is extremely limited.

Improved transplant method
The researchers intend to add islets of Langerhans to a special carrier medium, on which they will be trapped in millions of minuscule pockets. The carrier material is fully biocompatible (i.e. will not be rejected by the body) and promotes contact with the blood vessels. The islets then receive the oxygen they need and are far more likely to survive. In recent years, the MIRA Institute has gained considerable experience in similar techniques designed to promote the natural regeneration of bone and cartilage tissue.

Further research is needed to establish the precise location at which the cell medium should be implanted to maximize the benefits. The researchers believe that the new technique will be introduced into clinical practice within a few years, allowing islets from a human donor to be transplanted into a patient who needs them (an 'allograft'). Eventually, they hope to be able to produce islets using the patient's own stem cells, which can then be implanted back into the patient (an 'autograft').