Regulation of Inflammatory Response in Islet Transplantation

Abstract

Islet cell transplantation is a developing treatment for patients suffering from severe Type-1 diabetes. The long-term insulin independence after islet cell transplantation has been difficult to achieve, and this has been linked to several factors. One of the major cause of poor long-term outcome is inflammation surrounding the islets. Inflammation in islets is caused at several stages, donor induced, during organ preservation, islet isolation stress, peri-transplant inflammation or instant blood mediated inflammatory reaction (IBMIR), and post-transplant hypoxia. In addition to inflammation, auto/allo-immune attack causes rejection and the toxicity of the immunosuppressive agents used can also affect islet transplant outcomes. In this review, we will summarize the various inflammatory processes that occur during islet transplantation along with past and previous approaches used to reduce inflammation in pre-clinical and clinical studies.

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

“…However, there are several unanswered questions regarding the pathophysiological events occurring at the pre-, peri-and post-transplant moments. In this regrad, Shindo and Kanak [10] discuss the deleterious events impacting islets along the process of transplantation, including enzymatic and mechanical stress, cytokine-mediated injury, ischemicand hypoxia-mediated cell death, peri-transplant inflammation, allo-and autoimmune responses, as well as immunosuppression-induced β-cell toxicity. Furthermore, the authors synthesize past and ongoing efforts to tackle these issues, including clinical trials.…”