Phase-changing citrate macromolecule combats oxidative pancreatic islet damage, enables islet engraftment and function in the omentum

Sci Adv. 2024 Jun 7;10(23):eadk3081. doi: 10.1126/sciadv.adk3081. Epub 2024 Jun 7.

Abstract

Clinical outcomes for total-pancreatectomy followed by intraportal islet autotransplantation (TP-IAT) to treat chronic pancreatitis (CP) are suboptimal due to pancreas inflammation, oxidative stress during islet isolation, and harsh engraftment conditions in the liver's vasculature. We describe a thermoresponsive, antioxidant macromolecule poly(polyethylene glycol citrate-co-N-isopropylacrylamide) (PPCN) to protect islet redox status and function and to enable extrahepatic omentum islet engraftment. PPCN solution transitions from a liquid to a hydrogel at body temperature. Islets entrapped in PPCN and exposed to oxidative stress remain functional and support long-term euglycemia, in contrast to islets entrapped in a plasma-thrombin biologic scaffold. In the nonhuman primate (NHP) omentum, PPCN is well-tolerated and mostly resorbed without fibrosis at 3 months after implantation. In NHPs, autologous omentum islet transplantation using PPCN restores normoglycemia with minimal exogenous insulin requirements for >100 days. This preclinical study supports TP-IAT with PPCN in patients with CP and highlights antioxidant properties as a mechanism for islet function preservation.

MeSH terms

  • Animals
  • Antioxidants / pharmacology
  • Citric Acid / pharmacology
  • Humans
  • Islets of Langerhans Transplantation* / methods
  • Islets of Langerhans* / drug effects
  • Islets of Langerhans* / metabolism
  • Male
  • Omentum* / metabolism
  • Oxidative Stress* / drug effects
  • Pancreatitis, Chronic / metabolism
  • Pancreatitis, Chronic / pathology
  • Pancreatitis, Chronic / surgery
  • Phase Transition
  • Polyethylene Glycols / chemistry
  • Polyethylene Glycols / pharmacology

Substances

  • Citric Acid
  • Antioxidants
  • Polyethylene Glycols