The potential role of multifunctional human amniotic epithelial cells in pancreatic islet transplantation

Hilary E Murray, Ali Zafar, Khalid M Qureshi, Michelle B Paget, Clifford J Bailey, Richard Downing

Research output: Contribution to journalReview articlepeer-review


Pancreatic islet cell transplantation has proven efficacy as a treatment for type 1 diabetes mellitus, chiefly in individuals who are refractory to conventional insulin replacement therapy. At present its clinical use is restricted, firstly by the limited access to suitable donor organs but also due to factors associated with the current clinical transplant procedure which inadvertently impair the long-term functionality of the islet graft. Of note, the physical, biochemical, inflammatory, and immunological stresses to which islets are subjected, either during pretransplant processing or following implantation are detrimental to their sustained viability, necessitating repeated islet infusions to attain adequate glucose control. Progressive decline in functional beta (β)-cell mass leads to graft failure and the eventual re-instatement of exogenous insulin treatment. Strategies which protect and/or preserve optimal islet function in the peri-transplant period would improve clinical outcomes. Human amniotic epithelial cells (HAEC) exhibit both pluripotency and immune-privilege and are ideally suited for use in replacement and regenerative therapies. The HAEC secretome exhibits trophic, anti-inflammatory, and immunomodulatory properties of relevance to islet graft survival. Facilitated by β-cell supportive 3D cell culture systems, HAEC may be integrated with islets bringing them into close spatial arrangement where they may exert paracrine influences that support β-cell function, reduce hypoxia-induced islet injury, and alter islet alloreactivity. The present review details the potential of multifunctional HAEC in the context of islet transplantation, with a focus on the innate capabilities that may counter adverse events associated with the current clinical transplant protocol to achieve long-term islet graft function.
Original languageEnglish
Pages (from-to)599-611
Number of pages13
JournalJournal of Tissue Engineering and Regenerative Medicine
Issue number7
Early online date14 May 2021
Publication statusPublished - Jul 2021

Bibliographical note

This is the peer reviewed version of the following article: Murray, H.E., Zafar, A., Qureshi, K.M., Paget, M.B., Bailey, C.J. and Downing, R. (2021), The potential role of multifunctional human amniotic epithelial cells in pancreatic islet transplantation. J Tissue Eng Regen Med., which has been published in final form at  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

Funding: The Rowlands Trust, The Eveson Charitable Trust, James Tudor Foundation, The Sir Halley Stewart Trust, Worcestershire Acute Hospitals NHS Trust.


  • β‐cells
  • angiogenesis
  • human amniotic epithelial cells
  • immunomodulation
  • inflammation
  • islets
  • trophic
  • support


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