Advancing islet transplantation: from engraftment to the immune response.

Published

Journal Article (Review)

The promise and progress of islet transplantation for treating type 1 diabetes has been challenged by obstacles to patient accessibility and long-term graft function that may be overcome by integrating emerging technologies in biomaterials, drug delivery and immunomodulation. The hepatic microenvironment and traditional systemic immunosuppression stress the vulnerable islets and contribute to the limited success of transplantation. Locally delivering extracellular matrix proteins and trophic factors can enhance transplantation at extrahepatic sites by promoting islet engraftment, revascularisation and long-term function while avoiding unintended systemic effects. Cell- and cytokine-based therapies for immune cell recruitment and reprogramming can inhibit local and systemic immune system activation that normally attacks transplanted islets. Combined with antigen-specific immunotherapies, states of operational tolerance may be achievable, reducing or eliminating the long-term pharmaceutical burden. Integration of these technologies to enhance engraftment and combat rejection may help to advance the therapeutic efficacy and availability of islet transplantation.

Full Text

Duke Authors

Cited Authors

  • Gibly, RF; Graham, JG; Luo, X; Lowe, WL; Hering, BJ; Shea, LD

Published Date

  • October 2011

Published In

Volume / Issue

  • 54 / 10

Start / End Page

  • 2494 - 2505

PubMed ID

  • 21830149

Pubmed Central ID

  • 21830149

Electronic International Standard Serial Number (EISSN)

  • 1432-0428

Digital Object Identifier (DOI)

  • 10.1007/s00125-011-2243-0

Language

  • eng

Conference Location

  • Germany