Format

Send to:

Choose Destination
See comment in PubMed Commons below
Curr Opin Endocrinol Diabetes Obes. 2012 Aug;19(4):249-54. doi: 10.1097/MED.0b013e328355a2ec.

Clinical islet transplantation: where immunity and metabolism intersect?

Author information

  • 1Colorado Center for Transplantation Care, Research, and Education, University of Colorado, Denver, USA. Ronald.Gill@ucdenver.edu

Abstract

PURPOSE OF REVIEW:

The dramatic results of the Edmonton Protocol in 2000 triggered tremendous excitement over the application of pancreatic islet transplantation as a viable approach to achieving consistent insulin independence in type 1 diabetic patients. However, this optimism in the field was tempered by follow-up studies showing frequent attrition of graft function commonly requiring a return to exogenous insulin therapy within 1-3 years after transplant. The purpose of this review is to put these initial studies in perspective and to highlight progress and challenges in this important field.

RECENT FINDINGS:

Recent clinical and experimental findings demonstrate a progressive improvement in the function and durability of islet allografts. Induction therapies targeting T lymphocytes and costimulatory pathways have been highly effective at promoting islet transplant function. It is also apparent that islet injury associated with metabolic distress provides a nonimmune barrier to islet transplant outcomes.

SUMMARY:

Newer therapeutic interventions show great promise for attenuating the adaptive immune response to islet allografts. Also, clarifying the mechanisms of metabolic-related tissue distress may provide additional potential targets for improving islet graft outcomes.

PMID:
22647539
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk