FasL microgels induce immune acceptance of islet allografts in nonhuman primates.

FasL microgels induce immune acceptance of islet allografts in nonhuman primates.
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DOI:
10.1126/sciadv.abm9881
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发表时间:
2022-05-13
期刊:
影响因子:
13.6
通讯作者:
--
中科院分区:
综合性期刊1区
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--
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由于维持免疫抑制的需要,用于治疗胰岛素依赖性糖尿病的胰岛移植受到很大限制。我们报告了一种策略,通过该策略,在短暂的雷帕霉素单一疗法下,将同种异体胰岛和链霉亲和素(SA)-FasL-呈递的微凝胶共移植到大网膜,可实现稳健的血糖控制、持续的C肽水平以及糖尿病非人灵长类动物的移植物存活超过6个月。手术取出移植物导致迅速高血糖。相比之下,在相同的雷帕霉素方案下接受不含SA-FasL的微凝胶的动物会严重排斥胰岛移植物。移植物存活与移植部位 FoxP3+ 细胞数量增加相关,T 细胞系统频率或对供体和第三方抗原的反应没有显着变化,表明局部耐受。 SA-FasL 微凝胶的接受者表现出正常的肝脏和肾脏代谢功能,证明了安全性。这种局部免疫调节策略在未修饰的胰岛上取得了成功,并且不需要长期免疫抑制,显示出替代 β 细胞治疗 1 型糖尿病的转化潜力。同种异体胰岛和 FasL 微凝胶的移植可以在没有免疫抑制的情况下控制糖尿病灵长类动物的血糖。
Islet transplantation to treat insulin-dependent diabetes is greatly limited by the need for maintenance immunosuppression. We report a strategy through which cotransplantation of allogeneic islets and streptavidin (SA)–FasL–presenting microgels to the omentum under transient rapamycin monotherapy resulted in robust glycemic control, sustained C-peptide levels, and graft survival in diabetic nonhuman primates for >6 months. Surgical extraction of the graft resulted in prompt hyperglycemia. In contrast, animals receiving microgels without SA-FasL under the same rapamycin regimen rejected islet grafts acutely. Graft survival was associated with increased number of FoxP3+ cells in the graft site with no significant changes in T cell systemic frequencies or responses to donor and third-party antigens, indicating localized tolerance. Recipients of SA-FasL microgels exhibited normal liver and kidney metabolic function, demonstrating safety. This localized immunomodulatory strategy succeeded with unmodified islets and does not require long-term immunosuppression, showing translational potential in β cell replacement for treating type 1 diabetes. Transplantation of allo-islets and FasL microgels results in glycemic control in diabetic primates without immunosuppression.
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