Extracellular Matrix-Guided Islet Cell Transplantation Results in Improved Glycemic Control in a NOD-SCID Mouse Model.

Current insulin therapy fails to fully restore physiological glucose homeostasis in type 1 diabetes mellitus, with 75% of patients unable to achieve the desired management targets. While stem cell-derived islets offer promising therapy, they require an enhanced extracellular matrix support for optimal transplantation outcomes. To address this challenge, we developed biofunctional endocrine micro-pancreata using decellularized porcine lung scaffolds seeded with embryonic stem cell-derived islets. In vivo efficacy was evaluated following subcutaneous or intraperitoneal transplantation into NOD-SCID mice, followed by streptozotocin induction of diabetes, with the comprehensive assessment of human insulin secretion, glucose homeostasis, and graft integration over 3 months. Our results demonstrated that endocrine micro-pancreata exhibited 1.4-fold-increased glucose-stimulated insulin secretion in vitro compared to non-responsive free islets. In vivo, endocrine micro-pancreas recipients maintained significantly lower glucose levels than controls throughout the experiment. Subcutaneous endocrine micro-pancreata showed superior performance, with 46% improved glucose tolerance versus 31% improvement for intraperitoneal delivery. Extensive CD31-positive neovascularization as well as insulin staining confirmed successful graft integration and sustained insulin production. Endocrine micro-pancreata provide a scalable platform for diabetes cell therapy, demonstrating sustained insulin secretion and improved glycemic control. The preserved extracellular matrix microenvironment supports islet function and vascularization, offering significant potential for clinical translation.