PhD fellow at the Experimental Cell Transplantation group Simen W. Schive successfully defended his thesis Islet allotransplantation in Norway and the potential of adipose tissue-derived stromal cells to improve islet survival in October 2019. Dr. Schive has worked under the guidance of Senior Researcher Hanne Scholz studying islet allotransplanted patients and the possible future methods for improving patient outcome.
Thesis
summarized by Dr. Schive
In type 1
diabetes the beta cells are lost and can no longer synthesize the vital hormone
insulin. Islet allotransplantations can replace the lost beta cells. In this
thesis we describe the state of this treatment in Norway by reporting the cost
and clinical outcome for patients transplanted at our center in Oslo between
2010 – 2015. We compare our results to other centers and find similar results
for graft function and disease modification, and we highlight areas that can be
further improved. We also present the first documented pregnancy after
islet allotransplantation, with a successful outcome for both the pregnancy and
the transplanted graft. This is of particular relevance as many of the
potential recipients are females in their fertile age.
Despite an
increasing experience with islet transplantations worldwide, outcomes after
transplantation remains variable. Adipose tissue-derived stromal cells (ASCs)
have been shown to positively affect islets. In this thesis we describe how
soluble mediators released by human ASCs affect human islet viability in vitro,
and how exposing ASCs to a hypoxic environment increase the release of islet
trophic factors and decrease the levels of detrimental factors. We also show
how preconditioning ASCs in hypoxia improve their therapeutic efficiency in a
mouse diabetes model. Finally, we describe a method for large scale production
of ASCs using automated systems, a workflow that could be used for future clinical
trials.
Combining these elements, we describe both the present
situation of islet allotransplantation in Norway, and a possible route for
improving outcome in the future.
Public Defence: Simen W. Schive -
Institute of Clinical Medicine (uio.no)