title: Stem cell-based immunomodulation in type 1 diabetes: beyond the regenerative approach.
abstract: Type 1 diabetes (T1D) is an autoimmune disease, leading to pancreatic β-cell destruction and loss of glycaemic control. Administration of exogenous insulin to diabetic patients prevents life-threatening metabolic derangement, but may fail to prevent other longterm complications, such as kidney failure or diabetic retinopathy. Islet transplantation is a low-risk surgical procedure, affording improved glucose homeostasis provided sufficient islets engraft in the liver. Here we review work on the use of stem cells to generate β- cells for islet transplantation, indicating the need for improved protocols for their derivation and full maturation. We also consider recent evidence indicating that adult stem/progenitor cells may affect islet transplantation by improving the viability of engrafted islets and controlling immune reactions to islet allo- and auto-antigens, extending stem-cell use in T1D beyond the regenerative approach.
authors.affiliation: Department of Oncology, Transplantation and New Technologies in Medicine, University of Pisa, Ospedale Cisanello, Via Paradisa, 2, Pisa, Italy. biancamaria.longoni@med.unipi.it
authors.forename: Biancamaria
authors.initials: B
authors.lastname: Longoni
authors.forename: Franco
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000818:Animals; D001324:Autoantigens / Q000276:immunology; D002470:Cell Survival; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D050417:Insulin-Secreting Cells / Q000637:transplantation; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D033581:Stem Cell Transplantation / Q000379:methods*
chemical_list: D001324:Autoantigens