Small Wonders On A Cellular Battlefield
Like any valuable home, the worth of the BioHub is significantly enhanced by a new, more hospitable, neighborhood. The ?old neighborhood,? the site currently used for most islet transplants, is the liver. ?We see we can achieve a cure, when we transplant these [islet] cells today,? Stabler said. ?It?s just not a long-lasting cure. We can?t keep the cells alive. While the liver works well in some respects, we want to find a better site.?
One drawback to transplanting islets into the liver is their direct contact with blood. ?Whenever you have something foreign in your bloodstream, your blood clots,? she explained. ?While we may give anti-clotting drugs to help mitigate this, we still have a lot of inflammation. This inflammation is like waving a red flag to the immune system. It instigates a response that leads to the loss of islets.?
Another problem is the liver?s role in metabolizing drugs given to fight inflammation or suppress the immune system. ?When you take drugs, they get metabolized by your liver, so you have a higher concentration of them in the liver than elsewhere,? said Stabler. ?This is not necessarily good, because the drugs often have undesirable side effects on the islets. We know that many of the drugs we use for immunosuppression now cause islet dysfunction, and we want to avoid that.?
With these obstacles affecting the liver as a transplant site, the DRI?s preferred option is the omental pouch, or omentum, which hangs in front of the abdomen. ?The omentum is very interesting tissue,? Stabler pointed out. ?It appears that there are cells in it that facilitate healing and mitigate inflammation ? all the things you want when you transplant something. For example, many decades ago, if you had severe trauma to your hand, surgeons would open up your abdomen, wrap the omentum around your hand and suture your hand into your abdomen. After several weeks, they would unstitch you and remove the hand, and it would be healed.? The same nurturing properties should make the omentum an ideal place to implant the BioHub.
http://insulinnation.com/small-wonders/#.UTj9ZRx1GSo
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