Immunological Monitoring in Beta Cell Replacement: Towards a Pathophysiology-Guided Implementation of Biomarkers

Buron, Fanny; Reffet, S.; Badet, Lionel; Morélon, Emmanuel; Thaunat, Olivier

doi:10.1007/s11892-021-01386-4

Cited by 9 publications

(8 citation statements)

References 80 publications

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“…A quarter of patients may remain insulin independent, with HbA1c concentrations of less than or equal to 6.5%, for at least 10 years, with either islet transplantation alone or isletafter-kidney transplantation [55]. Moreover, the glucose control associated with excellent islet graft function closely matches glucose values measured in healthy adults: median glucose 103 mg/dL (95)(96)(97)(98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108)(109)(110)(111)(112), glucose standard deviation around the mean value 14 (11-20), 0% time >180 mg/dL, 0% time <54 mg/dL, HbA1c 5.6 (5-5.8) [56]. Additionally, a significant improvement of quality of life after islet transplant has been documented by using standardized psychometric instruments and interviews carried on by psychologists [47,[57][58][59][60][61][62][63][64].…”

Section: Islet Transplantation Todaymentioning

confidence: 73%

“…1). Efforts are ongoing to push to a broader dimension islet transplantation [54], including (i) implementation of scheme for donor and recipient selection and organ allocation to increase pancreas utilization [94][95][96]; (ii) improvement and standardization of islet isolation process and its best codification by regulatory bodies [97][98][99][100]; (iii) monitoring of transplanted islets by noninvasive imaging techniques [101,102]; (iv) development of biomarkers to assess the efficacy of the immunosuppression/immunomodulation strategies [92,[103][104][105][106][107]; (v) identification of alternative transplantation sites [108]; (vi) creation of an ideal bio-artificial niche for islet survival by bioengineering approaches [109,110]; and (vii) use of immune-isolation techniques, such as hydrogel polymers that shield pancreatic islet from immune cell attack [111,112]. On the other hand, there is increasing enthusiasm for the use of unlimited alternative sources of transplantable insulin-producing cells.…”

Section: New Horizon For the Treatment Of Diabetes With Cell Therapiesmentioning

confidence: 99%

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Cell Therapy for Type 1 Diabetes: From Islet Transplantation to Stem Cells

2022

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Background. The field of cell therapy of type 1 diabetes is a particularly interesting example in the scenario of regenerative medicine. In fact, β cell replacement has its roots in the experience of islet transplantation, which began 40 years ago, and is currently a rapidly accelerating field, with several ongoing clinical trials using β cells derived from stem cells. Summary. Type 1 diabetes is particularly suitable for cell therapy as it is a disease due to the deficiency of only one cell type, the insulin-producing β cell, and this endocrine cell does not need to be positioned inside the pancreas to perform its function. On the other hand, the presence of a double immunological barrier, the allogeneic one and the autoimmune one, make the protection of β cells from rejection a major challenge. Until today, islet transplantation has taught us a lot, pioneering immunosuppressive therapies, graft encapsulation, tissue engineering, test of different implant sites and has stimulated a great variety of studies on β cell function. Nowadays, it is indeed possible to generate functional β cells from the differentiation of pluripotent stem cells and the first pioneering clinical trials with these cells are ongoing. This review starts from islet transplantation, presenting its current indications and the latest published trials to arrive at the prospects of stem cell therapy, presenting the latest innovations in the field. Key messages. The field of β cell replacement is moving forward quickly, especially thanks to all the knowledge generated by the experience of islet transplantation.

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Section: Islet Transplantation Todaymentioning

confidence: 73%

Section: New Horizon For the Treatment Of Diabetes With Cell Therapiesmentioning

confidence: 99%

Cell Therapy for Type 1 Diabetes: From Islet Transplantation to Stem Cells

2022

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“…In islet transplantation the re-emergence of autoimmune reactivity may be as relevant as alloimmune responses directed against donor HLA and non-HLA targets. In addition, when considering the relevance of auto and alloimmune elements of the response to transplanted islets, both cellular and antibody reactivity needs to be considered (Buron et al, 2021). 20.1.17 The clinical team must inform the laboratory of events that might influence the HLA antibody profile and send a serum sample 14 days after the event.…”

Section: Islet Transplant Recommendationsmentioning

confidence: 99%

BSHI and BTS UK guideline on the detection of alloantibodies in solid organ (and islet) transplantation

Battle,

Pritchard,

Peacock

et al. 2023

Int J Immunogenetics

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Solid organ transplantation represents the best (and in many cases only) treatment option for patients with end‐stage organ failure. The effectiveness and functioning life of these transplants has improved each decade due to surgical and clinical advances, and accurate histocompatibility assessment. Patient exposure to alloantigen from another individual is a common occurrence and takes place through pregnancies, blood transfusions or previous transplantation. Such exposure to alloantigen's can lead to the formation of circulating alloreactive antibodies which can be deleterious to solid organ transplant outcome. The purpose of these guidelines is to update to the previous BSHI/BTS guidelines 2016 on the relevance, assessment, and management of alloantibodies within solid organ transplantation.

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“…From a viewpoint of preservation of β-cells through islet protection and regeneration, the humaninduced PSCs (iPSCs), hematopoietic stem cells (HSCs), human cord blood-derived multipotent stem cells (CB-SCs), and MSCs are being used. Additionally, stem cells are capable of re-establishing peripheral tolerance towards β-cells by remodeling of immune responses alongside inhibition of autoreactive T-cell function [85,86]. Stem cells have the potential to increase islet mass owing to their capability of differentiation to β-cells-like organoids.…”

Section: Promise and Challenges Of Stem Cell Derived Islet Cell Trans...mentioning

confidence: 99%

Molecular Challenges and Advances in Clinical Islet Transplantation

Mohan¹,

Sunder²

2023

Type 1 Diabetes in 2023 - From Real Practice to Open Questions

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The pathophysiology of diabetes is related to the levels of insulin within the body, and the body’s ability to utilize insulin. Patients with diabetes persistently go through life-threatening hypoglycaemia. Consequently, their quality of life gets affected, progressively leading them to micro- and macro-vascular complications. This is an unmanageable happening despite the technology advancements in insulin formulations. Nevertheless, islet transplantation is emerging as an alternative therapeutic option. Our chapter will elaborate on the recent advancements in this field highlighting the present-day challenges of clinical islet cell transplantation. Additionally, details about the advancements in cutting-edge clinical research, bio-molecular signaling with special reference to the pre and post transplant, the need for beta-cell replacement therapies, including the application of induced pluripotent stem cells and mesenchymal stem cells are also mentioned in this chapter.

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Immunological Monitoring in Beta Cell Replacement: Towards a Pathophysiology-Guided Implementation of Biomarkers

Cited by 9 publications

References 80 publications

Cell Therapy for Type 1 Diabetes: From Islet Transplantation to Stem Cells

Cell Therapy for Type 1 Diabetes: From Islet Transplantation to Stem Cells

BSHI and BTS UK guideline on the detection of alloantibodies in solid organ (and islet) transplantation

Molecular Challenges and Advances in Clinical Islet Transplantation

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