Type 1 diabetes (T1D) results in hyperglycemia, increased risk for secondary complications, and life-long dependence on exogenous insulin. Islet transplantation is a promising alternative to insulin therapy for T1D treatment. However, long-term function of islets transplanted into the FDA approved hepatic portal vein remains low, with much of the islet mass being lost early after transplantation due to immune responses and drug toxicity. These challenges have prompted a search for alternative transplantation sites that are readily accessible, immune-privileged, offer graft retrievability, and promote islet survival. A novel site that exhibits these traits is brown adipose tissue (BAT), which is highly vascularized, innervated, and contains immunomodulatory immune cells. BAT functions to maintain thermogenesis and can regulate metabolic homeostasis. We hypothesize that islet engraftment in BAT can restore euglycemia in diabetic mice, promote revascularization, and delay immune rejection. Syngeneic transplantation of 250 NOD.scid islets into the BAT of streptozotocin (STZ)-treated diabetic NOD.scid mice restored euglycemia for over two months, similar to islets transplanted under the pre-clinical kidney capsule transplant site. Islet function was also comparable across transplant groups as measured by a glucose tolerance test. BAT thermogenic function during a cold challenge showed no difference in cold tolerance after transplantation. Histology and mRNA analysis revealed BAT engrafted islets expressed islet hormones, functional islet transcription factors, and CD31+ vascularization at the islet graft site. Overall, our data suggest BAT is a novel and efficacious site for islet transplantation. Future islet transplant studies will determine if the inherent properties of BAT can extend the longevity of transplanted islets by investigating the immunomodulatory capacity of BAT-resident mesenchymal stem cells and immune cells, compared to current transplantation sites.
J. Barra: None. J. Kepple: None. H.M. Tse: None. C.S. Hunter: None.
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK099550); JDRF (SRA-2016-270-S-B, 2-SRA-2019-692-S-B); National Institute of General Medical Sciences (T32GM008111)