Autoimmune diabetic patients undergoing allogeneic islet transplantation: are we ready for a regulatory T-cell therapy?
Regulatory T cells (Tregs) are thought to be pivotal in controlling both autoimmune and allogeneic undesired immune responses. Recently, an extensive effort has been devoted to design clinical trials with Tregs in T cell-mediated diseases (such as autoimmune diseases or transplantation). Theoretically, this approach can be used also in patients with autoimmunity (e.g., type 1 diabetes) undergoing allogeneic transplantation (e.g., pancreatic islet transplant). However, in this latter case Tregs must control two distinct effector immune responses: a pre-existing response towards self-antigens and a de novo response induced by the newly transplanted allogeneic cells. In this review we summarize results supporting the use of Tregs in controlling either autoimmunity or allo-transplantation. We also provide our view on how Treg therapy can achieve the final goal of immunological tolerance in the extremely challenging clinical setting of type 1 diabetic subjects transplanted with allogeneic islets.
Gagliani
Nicola
N
San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), 20132 Milano, Italy.
Ferraro
Alessandra
A
Roncarolo
Maria Grazia
MG
Battaglia
Manuela
M
D000818:Animals; D015551:Autoimmunity; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000628:therapy; D006084:Graft Rejection / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007108:Immune Tolerance; D016219:Immunotherapy, Adoptive; D016381:Islets of Langerhans Transplantation; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D014184:Transplantation, Homologous