Advancing islet transplantation: From engraftment to the immune response

R. F. Gibly, J. G. Graham, X. Luo, W. L. Lowe, B. J. Hering, L. D. Shea*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

118 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2494-2505
Number of pages12
JournalDiabetologia
Volume54
Issue number10
DOIs
StatePublished - Oct 2011

Funding

Acknowledgements Financial support was provided by grants from NIH & NIDDK, including: F30 DK846492, R21 EB009502, R01 EB009910, DP2 DK083099 and U01 AI089316.

Keywords

  • Biomaterial
  • Biotechnology
  • Diabetes
  • Extrahepatic
  • Immunomodulation
  • Islet transplantation
  • Review
  • Scaffold
  • Tissue engineering
  • Tolerance

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Fingerprint

Dive into the research topics of 'Advancing islet transplantation: From engraftment to the immune response'. Together they form a unique fingerprint.

Cite this