CBE/ENGR 225 Faculty Seminar Series Presents: Jonathan Lakey, Ph.D., MSM, UC Irvine, Tues., May 15, 2018

Thursday, May 15, 2018 at 4pm in ESB 2001

Jonathan Robert Todd Lakey, Ph.D., MSM

Professor, Director of Clinical Islet Program, Surgery
School of Medicine

Adjunct, Professor, Biomedical Engineering
The Henry Samueli School of Engineering

University of California, Irvine


Tuesday, May 15, 2018

ESB #2001


*Light refreshments will be provided*


Host: Sumita Pennathur


Update on Islet Transplantation for Type 1 Diabetes


The current treatment paradigm for type 1 diabetes (T1D) involves frequent blood glucose monitoring and lifelong insulin injections several times a day. Since T1D is typically diagnosed at a very young age, patients often cannot comply with such a strict treatment regimen, often leading to long-term complications. Islet transplantation, a surgical procedure involving transplantation of insulin-secreting cells into T1D patients, is a promising candidate as a long-lasting treatment option for T1D, as it has several significant advantages to conventional insulin therapy; a significant reduction in the need for insulin injections, better blood glucose control and an overall improvement in the quality of life in T1D patients. However, this procedure is not without its disadvantages. Typically, the insulin-secreting cells are transplanted into the liver through a large vein located deep in the abdomen called the portal vein; the procedure is moderately invasive, requires anesthesia and the use of blood-thinning agents. Additionally, a significant portion of the transplanted islets is destroyed immediately on contact with the blood in the vein due to an instant inflammatory reaction. Thus, liver is not the best site for islet transplantation. Better implantation sites are urgently needed.
            While choosing a site for islet transplantation, a few criteria should be borne in mind – the sites should not only be suitable for islets, but also for new emerging sources of insulin-producing cells, since islets from human cadaver donors are frustratingly hard to come by. Preferably such a site should also be readily accessible to allow re-implantation, if required, and retrieval, as some new emerging sources of insulin-producing cells such as stem cells might need regular replacement. Our multicenter multi-investigator team of experts in the fields of transplantation, biomedical engineering, and immunology firmly believes the site that best meets all our requirements, and is thus most likely to be successful, is right under the skin, also called the ‘subcutaneous’ site. 

            Using a retrievable ‘scaffold’ that can be placed under the skin and trigger the growth of blood vessels and nerves into the scaffold, before filling it with islets. After implanting the scaffold under the skin, we will inject therapeutic agents proven to trigger blood vessel and nerve growth directly into the surgical site and wait a few weeks to allow blood vessels and nerves to develop into the scaffold. We will monitor the site to identify whether the scaffold is ready to be ‘filled’ with insulin-secreting cells. We will also incorporate strategies to prevent the immune system from destroying the foreign cells using biological agents that have been proven to be safe and effective.

We believe that our blood vessel and nerve-rich scaffold will provide better nutrition and oxygen to the implanted cells, leading to higher survival rates and a faster response of the transplanted islets to glucose through signals from the nervous system. If successful, our revolutionary approach will make islet transplantation a simpler, safer and much more effective procedure and significantly widens the scope of its application in T1D patients of all ages, and pre-existing conditions, some of which would preclude them from being candidates for conventional islet transplantation.