Immunological aspects of pancreatic islet cell transplantation.
Type 1 diabetes mellitus (T1DM) is one of the most common diseases of childhood. Insulin discovery changed the clinical course of T1DM from an acutely fatal disease to a chronic disease, but this discovery was later found to be inefficient to control its long-term complications. Whole-pancreas and islet cell transplantation seem to provide a potential solution by restoring the normal physiology of glucose-insulin homeostasis. Although islet transplantation is less invasive than whole-pancreas transplantation, the insulin-free state after islet transplantation remained low (10%) at 5 years after surgery. Here, we will present the specific immunologic challenges that are specific to islet cell transplantation, including instant blood-mediated inflammatory reaction and the recurrence of autoimmunity. We will also briefly discuss the immunosuppressive regimens used and the recent radiologic techniques in the detection of engraftment and early rejection of islet cells.
Azzi
Jamil
J
Transplantation Research Center (TRC), Brigham and Women's Hospital, Harvard Medical School, 227 Longwood Avenue, Boston, MA 02115, USA. jazzi@rics.bwh.harvard.edu
Geara
Abdallah S
AS
El-Sayegh
Suzanne
S
Abdi
Reza
R
D000818:Animals; D015551:Autoimmunity / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000601:surgery*; D006084:Graft Rejection / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007249:Inflammation / Q000276:immunology / Q000517:prevention & control; D018836:Inflammation Mediators / Q000097:blood; D016381:Islets of Langerhans Transplantation / Q000276:immunology*; D013997:Time Factors; D023001:Transplantation Tolerance / Q000187:drug effects; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D018836:Inflammation Mediators