Pancreatic islet isolation and transplantation following the Edmonton Protocol offer life-altering results for diabetes patients, but injury and stress to cells during the process are major obstacles for achieving effective post-transplant functional performance. One of the issues is oxidative stress due to low antioxidant capacity in islets, highly detrimental when cells are challenged with ischemia and reperfusion injury. In an effort to overcome this, Dr Gina Rayat and a collaborative team that included former Alberta Diabetes Institute Founding Scientific Director Dr Ray Rajotte and fruit scientists from Zhejiang University in China, explored the use of cyanidin-3-O-glucoside (C3G), an anthocyanin with powerful antioxidant properties derived from the Chinese bayberry that has been also used in other medical applications. The group had previously shown that isolated mouse islets cultured with C3G increased expression of various genes related to enhanced survival, including HO-1, ERK 1/2 and P13K/Akt, with knockout of these genes nullifying the advantage. In a more recent study they isolated islets from mouse pancreases and cultured them with and without C3G for 24 hours before transplanting the islets under the kidney capsule of recipient mice that had been rendered diabetic with streptozotocin. They found that mouse recipients of 400 or 200 C3G-treated islets achieved normoglycemia significantly faster than mouse recipients of untreated islets – 10 days vs. 13 days and 10 days vs. 18 days, respectively. Even more, animals that received just 100 C3G-treated islets achieved normoglycemia within 27 days, whereas mice transplanted with the same number of untreated islets failed to show lowering of blood glucose. When the investigators repeated the experiment using the portal vein as site for transplantation they found that islets were less efficient in attaining normoglycemia. For example, 40% and 20% of mice transplanted with 200 and 100 C3G-treated islets, respectively were able to achieve normoglycemia, when the transplant was into the portal vein of the liver. This compares with 100% success when similar numbers were transplanted under the kidney capsule. While the latter site may not be practical in human applications, it does demonstrate the importance of transplantation site for islet survival, even with antioxidant treatment. Regardless of site though, their results show that pre-treatment with C3G enhances both viability and function of islets after transplantation and encourages further research into the use of antioxidants (Transplantation, 99:508-514, 2015). Dr Rayat and her group are currently testing the effect of C3G on pig and human islets.