Co-transplantation of pancreatic islets with adipose-derived mesenchymal stem cells in vascularized kidney ECM scaffolds to restore type 1 diabetes mellitus.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Type 1 diabetes mellitus (T1DM) requires innovative strategies to restore insulin production while overcoming immune rejection and limited donor availability. In this study, we developed a bioengineered insulin-producing tissue (IPT) by combining isolated pancreatic islets with adipose-derived stem cells (ADSCs) on a decellularized kidney extracellular matrix (k-ECM). Instead of discarding the substandard conditions islets, we demonstrate that they provide valuable bioactive signals like cytokines, growth factors, and extracellular matrix cues, which promote ADSCs differentiation into functional insulin-producing cells (IPCs). Moreover, the vascularized microstructure of k-ECM closely resembles pancreatic tissue, further supporting islet viability, and the co-culture of islets with ADSCs promotes revascularization and immunomodulation. In vitro results demonstrated that islet/ADSC/k-ECM enhances structural support, insulin secretion, and ADSC differentiation into IPCs. In vivo implantation of the islet/ADSC/k-ECM construct in a rat T1DM model restored fasting blood glucose (FBS), increased insulin secretion, angiogenesis, muscle thickness, immunomodulatory effects, and differentiation of ADSCs into IPCs, confirmed by immunohistochemistry (IHC) and RNA-seq. Collectively, this study demonstrates that the islet/ADSC/k-ECM (ILAE) construct creates a vascularized, insulin-producing,

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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