Advancing islet transplantation: from engraftment to the immune response.
Advancing islet transplantation: from engraftment to the immune response.
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DOI：
10.1007/s00125-011-2243-0
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发表时间：
2011-10
期刊：
影响因子：
8.2
通讯作者：
Shea, L. D.
中科院分区：
文献类型：
--
作者：
Gibly, R. F.;Graham, J. G.;Luo, X.;Lowe, W. L., Jr.;Hering, B. J.;Shea, L. D.
关键词：
胰岛移植治疗1型糖尿病的前景和进展一直受到患者可及性和长期移植物功能障碍的挑战，这些障碍可能通过整合生物材料、药物输送和免疫调节等新兴技术来克服。肝脏微环境和传统的全身性免疫抑制对脆弱的胰岛造成压力，导致移植成功率有限。局部递送细胞外基质蛋白和营养因子可以通过促进胰岛移植、血管重建和长期功能来增强肝外部位的移植，同时避免意外的全身效应。基于细胞和细胞因子的免疫细胞募集和重编程疗法可以抑制通常攻击移植胰岛的局部和全身免疫系统激活。结合抗原特异性免疫疗法，可以实现手术耐受状态，减少或消除长期药物负担。整合这些技术来增强移植和对抗排斥可能有助于提高胰岛移植的治疗效果和可用性。
The promise and progress of islet transplantation for treating type 1 diabetes has been challenged by obstacles to patient accessibility and long-term graft function that may be overcome by integrating emerging technologies in biomaterials, drug delivery and immunomodulation. The hepatic microenvironment and traditional systemic immunosuppression stress the vulnerable islets and contribute to the limited success of transplantation. Locally delivering extracellular matrix proteins and trophic factors can enhance transplantation at extrahepatic sites by promoting islet engraftment, revascularisation and long-term function while avoiding unintended systemic effects. Cell- and cytokine-based therapies for immune cell recruitment and reprogramming can inhibit local and systemic immune system activation that normally attacks transplanted islets. Combined with antigen-specific immunotherapies, states of operational tolerance may be achievable, reducing or eliminating the long-term pharmaceutical burden. Integration of these technologies to enhance engraftment and combat rejection may help to advance the therapeutic efficacy and availability of islet transplantation.
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