Advances in Allogeneic and Autologous Islet Transplantation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (25 February 2022) | Viewed by 4548

Special Issue Editor


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Guest Editor
Department of Hepato-pancreato-biliary Surgery and Transplantation, Kyoto University, Kyoto 606-8507, Japan
Interests: pancreatic surgery; islet transplantation; liver and pancreas transplantation; cell transplantation; transplant immunology; regenerative medicine; regulatory T cell; hepato-pancreato-biliary disease treatment

Special Issue Information

Dear Colleagues,

In hepato-pancreato-biliary disease treatment, pancreatic islet transplantation is the most clinically successful cell transplantation. Allogeneic islet transplantation can effectively treat patients with type 1 diabetes with intractable impaired awareness of hypoglycemia and severe hypoglycemic events. Patients with painful chronic pancreatitis undergoing total pancreatectomy may receive islet autotransplantation to prevent surgical diabetes. A disadvantage of allogeneic islet transplantation is that donors are essential; however, with the recent development of alternative transplantation sites and new cell sources, including porcine islet cells and ES/iPS derived β cells, “On-demand” and “Unlimited” cell therapy can be established in the near future. The development of alternative transplantation sites may also bring about remarkable advances in autologous islet transplantation. The purpose of this Special Issue is to present the latest knowledge and future prospects of allogeneic and autologous islet transplantation, including clinical, translational and basic research.

Dr. Takayuki Anazawa
Guest Editor

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Keywords

  • Allogeneic islet transplantation
  • Total pancreatectomy with islet autotransplantation
  • Type 1 diabetes
  • Chronic pancreatitis
  • Hypoglycemia
  • Cell transplantation

Published Papers (2 papers)

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Review

11 pages, 463 KiB  
Review
The History of Clinical Islet Transplantation in Japan
by Taihei Ito, Takashi Kenmochi, Kei Kurihara and Naohiro Aida
J. Clin. Med. 2022, 11(6), 1645; https://doi.org/10.3390/jcm11061645 - 16 Mar 2022
Cited by 3 | Viewed by 1836
Abstract
Islet transplantation shows the promise of being capable of relieving glucose instability and improving QOL of patients with type 1 diabetes that cannot be controlled due to severe hypoglycemia unawareness. In Japan, following the first human islet isolation from a donor after cardiac [...] Read more.
Islet transplantation shows the promise of being capable of relieving glucose instability and improving QOL of patients with type 1 diabetes that cannot be controlled due to severe hypoglycemia unawareness. In Japan, following the first human islet isolation from a donor after cardiac death in 2003 and the first clinical islet transplantation in 2004, islet transplantation was performed for the improvement of type 1 diabetes as a single-center trial in several centers. Although it was discontinued due to the possibility of contamination of collagenase by bovine brain component in 2007, the phase II clinical trial of islet transplantation started using ATG induction and a TNF-α inhibition protocol in 2012. The primary endpoints of this trial were the proportion of patients with HbA1c < 7.4% and freedom from severe hypoglycemic events at one year after the first islet cell infusion. In an interim analysis, this endpoint was achieved in 75% of cases. In April 2020, clinical islet transplantation was finally covered by health insurance in Japan, thanks to these outcomes. We herein introduce more than 20 years of history of clinical islet transplantation in Japan. Full article
(This article belongs to the Special Issue Advances in Allogeneic and Autologous Islet Transplantation)
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13 pages, 6843 KiB  
Review
Induction of Immune Tolerance in Islet Transplantation Using Apoptotic Donor Leukocytes
by Naoya Sato and Shigeru Marubashi
J. Clin. Med. 2021, 10(22), 5306; https://doi.org/10.3390/jcm10225306 - 15 Nov 2021
Cited by 4 | Viewed by 2138
Abstract
Allogeneic islet transplantation has become an effective treatment option for severe Type 1 diabetes with intractable impaired awareness due to hypoglycemic events. Although current immunosuppressive protocols effectively prevent the acute rejection associated with initial T cell activation in recipients, chronic rejection has remained [...] Read more.
Allogeneic islet transplantation has become an effective treatment option for severe Type 1 diabetes with intractable impaired awareness due to hypoglycemic events. Although current immunosuppressive protocols effectively prevent the acute rejection associated with initial T cell activation in recipients, chronic rejection has remained an obstacle for achieving long-term allogeneic islet engraftment. The development of donor-specific immune tolerance to the allograft is the ultimate goal given its potential ability to overcome chronic rejection and disregard the need for maintenance immunosuppression, which may be toxic to islet grafts. Recently, a breakthrough in tolerance induction during allogeneic islet transplantation using apoptotic donor lymphocytes (ADLs) in a non-human primate model had been reported. Several studies have suggested that the clonal depletion, anergy, and expansion of the antigen-specific regulatory immune network are the mechanisms for donor-specific tolerance with ADLs, which act synergistically to induce robust transplant tolerance. This achievement represents a huge step forward toward the clinical application of immune tolerance induction. We herein summarize the reported operational induction therapies in islet transplantation using the ADLs. Moreover, a few obstacles for the engraftment of transplanted islets, such as islet immunogenicity and instant blood-mediated response, which need to be resolved in the future, are also discussed. Full article
(This article belongs to the Special Issue Advances in Allogeneic and Autologous Islet Transplantation)
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