Strategies for inducing immunological tolerance of xenogeneic islet transplants in type I diabetes.
The increased need for organ transplantation in diabetic patients requires the development of alternatives to allotransplantation, such as xenotransplantation. However, this approach is limited at the present time by important immunological barriers related to the presence of xenogeneic antibodies capable of rapid activation of the complement pathway. Improved understanding of the acute rejection phase has led to the development of specific animal donors and raises the question of the control of secondary cellular reaction against the xenograft. Several discordant or concordant xenograft models have been used to test different strategies for inducing permanent immunological tolerance in the absence of chronic immunosuppression. However, additional studies in non-human primates are clearly needed before clinical applications can be carried out. Several problems also need to be solved, such as autoimmune recurrence and biological hazards due to porcine retroviruses.
Department of Endocrinology, Edouard Herriot Hospital Lyon, France. thivolet@cimac-res.univ-lyon1.fr
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D000818:Animals; D000917:Antibody Formation; D003165:Complement System Proteins / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000601:surgery*; D006084:Graft Rejection; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology*; D007111:Immunity, Cellular; D016381:Islets of Langerhans Transplantation; D014183:Transplantation, Heterologous
D003165:Complement System Proteins