Targeting Acute Islet Inflammation to Preserve Graft Mass and Long-Term Function

Abstract

Islet transplantation is a minimally invasive cell based replacement therapy to prevent or reverse diabetes or hypoglycemia through natural hormonal responses to regulate blood glucose. However, extending the islet graft functional lifespan remains a challenge that prevents long-term success and widespread use of the procedure. Islets are subject to stress and damage and undergo immunological assault during transplantation procedures. Current treatments to prevent immune reactivity toward the graft come with toxic side effects, and damage to islets and loss of graft function still occurs. Accumulating evidence suggests that acute inflammatory reactions contribute to a significant loss of islet cell mass early in the transplant process. Inflammatory reactions involving a blood coagulation cascade and communication between islet cells and immune cells can destroy more than half the islet

Islet Transplantation: How Much Have We Advanced and How to Keep Moving Forward?

“…Similarly, Quintana et al [11] elaborate on chemical strategies to improve islet transplant outcomes and provide a thorough and wellreferenced recapitulation of molecular therapeutics and encapsulation strategies to protect islets from innate and adaptive immune responses. Finally, Darden et al [12] contribute with a more focused review on the innate and adaptive immune responses and their impact on long-term graft function. It is an unequivocal fact that a comprehensive knowledge of the issues surrounding the initial inflammatory processes and immune responses is indispensable for researchers and clinicians working in islet transplantation and the works of Shindo and Kanak, Quintana et al, and Darden et al represent an excellent starting point.…”