title: Biologic agents in islet transplantation.
abstract: Islet transplantation is today an accepted modality for treating selected patients with frequent hypoglycemic events or severe glycemic lability. Despite tremendous progress in islet isolation, culture, and preservation, clinical use is still restricted to a limited subset, and lifelong immunosuppression is required. Issues surrounding limited islet revascularization and immune destruction remain. One of the major challenges is to prevent alloreactivity and recurrence of autoimmunity against β-cells. These two hurdles can be effectively reduced by immunosuppressive therapy combining induction and maintenance treatments. The introduction of highly potent and selective biologic agents has significantly reduced the frequency of acute rejection and has prolonged graft survival, while minimizing the complications of this therapeutic scheme. This review will address the most important biological agents used in islet transplantation. We provide a historical perspective of their introduction into clinical practice and their role in current clinical protocols, aiming at improved engraftment efficiency, increased long-term survival, and better overall results of clinical islet transplantation.
authors.affiliation: Clinical Islet Transplant Program and Department of Surgery, University of Alberta, Edmonton, AB, Canada.
authors.forename: Boris
authors.initials: B
authors.lastname: Gala-Lopez
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Pepper
authors.forename: A M James
authors.initials: AM
authors.lastname: Shapiro
mesh_terms: D000818:Animals; D001685:Biological Factors / Q000266:history / Q000494:pharmacology* / Q000627:therapeutic use; D049673:History, 20th Century; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D016381:Islets of Langerhans Transplantation
chemical_list: D001685:Biological Factors
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