A view on beta cell transplantation in diabetes.
Organ donors also offer a source of insulin-producing tissue that might be used for the treatment of diabetes. Clinical protocols for transplantation of this tissue aim for the prevention of chronic diabetes complications without introducing new serious side effects. Pancreas and islet cell transplantation are discussed in this perspective. The future of islet cell implants looks favorable but depends on finding ways to induce immune tolerance to the donor beta cells. Clinical trials can take advantage of relevant progress in animal models. In a limited study, recipient treatment with antilymphocyte antibodies and culture of donor cell preparations appeared useful to induce a state of operational immune tolerance in type 1 diabetic patients, as indirectly judged by graft survival and by analysis of auto- and alloreactivities in recipients. Use of cultured beta cell preparations also allows donor cell recruitment from suboptimal donor organs and increases the degree of standardization and quality control of islet cell grafts. The future of these grafts will depend on the development of techniques for the neogenesis of beta cells.
Pipeleers
Daniel
D
Free University of Brussels (VUB), Brussels, Belgium. Daniel.Pipeleers@vub.ac.be
Keymeulen
Bart
B
Chatenoud
Lucienne
L
Hendrieckx
Christel
C
Ling
Zhidong
Z
Mathieu
Chantal
C
Roep
Bart
B
Ysebaert
Dirk
D
D000818:Animals; D000961:Antilymphocyte Serum / Q000276:immunology / Q000494:pharmacology / Q000627:therapeutic use; D018929:Cell Culture Techniques; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007165:Immunosuppression Therapy; D007515:Islets of Langerhans / Q000166:cytology; D016381:Islets of Langerhans Transplantation / Q000276:immunology* / Q000639:trends*; D023001:Transplantation Tolerance / Q000187:drug effects
D000961:Antilymphocyte Serum