title: Mesenchymal stromal cells as a means of controlling pathological T-cell responses in allogeneic islet transplantation.
abstract: OBJECTIVE
  To evaluate the potential for mesenchymal stromal cells (MSCs) to regulate T-cell responses responsible for graft destruction following allogeneic islet transplantation (AIT).
  
  
  RESULTS
  Despite a high level of primary graft function being observed in most individuals following AIT, the majority of recipients require exogenous insulin within 5 years, presumably due to graft attrition. Although this process is not fully understood, recent evidence suggests that a combination of chronic allograft rejection and/or the recrudescence of anti-islet autoimmunity govern islet loss. Emerging reports highlight that the pathology of AIT may involve the proliferation, effector function and homeostatic expansion of alloreactive and autoreactive T-cell pools. MSCs exhibit several desirable characteristics, which may advocate their use in AIT. This includes the capacity to suppress alloreactive and autoimmune T-cell responses, and promote a cytokine environment that is likely to be graft protective. However, further work is needed to clarify if MSCs can function in the setting of immune suppression and discern how they may effect T-cell effector functions and influence homeostatic expansion.
  
  
  CONCLUSIONS
  MSCs exhibit the potential to regulate the T-cell-driven processes that underlie disease pathology in AIT, but further study may be required to maximize their therapeutic efficacy.
authors.affiliation: Department of Immunobiology, King's College London, Guy's Hospital, London, UK.
authors.forename: James L
authors.initials: JL
authors.lastname: Reading
authors.forename: Shereen
authors.initials: S
authors.lastname: Sabbah
authors.forename: Sarah
authors.initials: S
authors.lastname: Busch
authors.forename: Timothy I M
authors.initials: TI
authors.lastname: Tree
mesh_terms: D000818:Animals; D015551:Autoimmunity / Q000276:immunology; D016207:Cytokines / Q000276:immunology; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000276:immunology; D016381:Islets of Langerhans Transplantation / Q000276:immunology*; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000276:immunology*; D051379:Mice; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous / Q000276:immunology
chemical_list: D016207:Cytokines; D007166:Immunosuppressive Agents