Pig-to-Primate Islet Xenotransplantation: Past, Present, and Future.
Islet allotransplantation results in increasing success in treating type 1 diabetes, but the shortage of deceased human donor pancreata limits progress. Islet xenotransplantation, using pigs as a source of islets, is a promising approach to overcome this limitation. The greatest obstacle is the primate immune/inflammatory response to the porcine (pig) islets, which may take the form of rapid early graft rejection (the instant blood-mediated inflammatory reaction) or T-cell-mediated rejection. These problems are being resolved by the genetic engineering of the source pigs combined with improved immunosuppressive therapy. The results of pig-to-diabetic nonhuman primate islet xenotransplantation are steadily improving, with insulin independence being achieved for periods >1 year. An alternative approach is to isolate islets within a micro- or macroencapsulation device aimed at protecting them from the human recipient's immune response. Clinical trials using this approach are currently underway. This review focuses on the major aspects of pig-to-primate islet xenotransplantation and its potential for treatment of type 1 diabetes.
Zhengzhao
Z
Liu
Wenbao
W
Hu
Tian
T
He
Yifan
Y
Dai
Hidetaka
H
Hara
Rita
R
Bottino
David K C
DKC
Cooper
Zhiming
Z
Cai
Lisha
L
Mou
D000818:Animals; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D006084:Graft Rejection; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D011323:Primates; D013552:Swine; D014183:Transplantation, Heterologous / Q000379:methods*