Immunosuppression in islet transplantation.

The Journal of Clinical Investigation
Tom Van Belle, Matthias von Herrath

Abstract

Islet transplantation can temporarily cure type 1 diabetes mellitus (T1DM) but requires simultaneous immunosuppression to avoid allograft rejection. In this issue of the JCI, Monti et al. report that immune conditioning via use of the Edmonton protocol - a treatment approach in which T1DM patients infused with pancreatic islets from multiple cadaveric donors simultaneously receive immunosuppressive drugs - results in lymphopenia that is associated with elevated serum levels of the homeostatic cytokines IL-7 and IL-15, which causes in vivo expansion of the autoreactive CD8(+) T cell population (see the related article beginning on page 1806). Reemergence of autoreactivity is likely the main culprit underlying long-term islet graft failure, and new strategies will need to be tested to circumvent this homeostatic expansion and recurrent autoreactivity.

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Citations

Sep 14, 2012·Journal of Molecular Histology·JiaQing GongYonghua Wang
Dec 2, 2010·Pediatric Diabetes·Paul Benitez-Aguirre, David M Maahs
May 1, 2020·The Journal of Immunology : Official Journal of the American Association of Immunologists·Paul J BelmonteVirginia Smith Shapiro

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