Potent induction immunotherapy promotes long-term insulin independence after islet transplantation in type 1 diabetes.
Potent induction immunotherapy promotes long-term insulin independence after islet transplantation in type 1 diabetes.
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DOI：
10.1111/j.1600-6143.2011.03977.x
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发表时间：
2012-06
期刊：
影响因子：
--
通讯作者：
Hering BJ
中科院分区：
文献类型：
--
作者：
Bellin MD;Barton FB;Heitman A;Harmon JV;Kandaswamy R;Balamurugan AN;Sutherland DE;Alejandro R;Hering BJ
单独胰岛移植(ITA)后胰岛素独立性似乎不可避免地下降，这引起了人们对其临床应用的担忧。我们假设诱导免疫抑制治疗决定了胰岛素非依赖性的持久性。我们根据诱导免疫治疗分析了四组胰岛移植受者中胰岛素非依赖性患者的比例：明尼苏达大学的受者只接受FCR非结合抗CD3抗体或T细胞去除抗体和肿瘤坏死因子-α抑制(TCDAb)和肿瘤坏死因子-α-I(n=29)；向协作性胰岛移植注册中心报告的受者接受TCDAb+肿瘤坏死因子-α-I(组2；n=20)；CITR受者接受TCDAb而不接受肿瘤坏死因子-α-I(组3；n=43)；和CITR受者仅给予IL-2受体抗体(IL-2RAb)(组4，n=177)。结果与向移植受者科学登记(第5组；n=677)报告的单独胰腺移植(PTA)受者的结果进行比较。第1组(50%)和第2组(50%)的5年胰岛素独立率与PTA(第5组：52%；p>；>；005)相似，但显著高于第3组(0%；p=0.001)和第4组(20%；p=0.02)。无论维持免疫抑制或其他因素如何，诱导性免疫抑制与胰岛素5年的独立性显著相关(p=0.03)。这些发现支持在ITA后使用有效的诱导治疗，使用抗CD3Ab或TCDAb+肿瘤坏死因子-α-I进行长期胰岛素独立的可能性。
The seemingly inexorable decline in insulin independence after islet transplant alone (ITA) has raised concern about its clinical utility. We hypothesized that induction immunosuppression therapy determines durability of insulin independence. We analyzed the proportion of insulin independent patients following final islet infusion in four groups of ITA recipients according to induction immunotherapy: University of Minnesota recipients given FcR nonbinding anti-CD3 antibody alone or T cell depleting antibodies (TCDAb) and TNF-α inhibition (TNF-α-i) (Group 1;n=29); recipients reported to the Collaborative Islet Transplant Registry (CITR) given TCDAb+TNF-α-i (Group 2; n=20); CITR recipients given TCDAb without TNF-α-i (Group 3;n=43); and CITR recipients given IL-2 receptor antibodies (IL-2RAb) alone (Group 4,n=177). Results were compared with outcomes in pancreas transplant alone (PTA) recipients reported to the Scientific Registry of Transplant Recipients (Group 5;n=677). 5-yr insulin independence rates in Group 1 (50%) and Group 2 (50%) were comparable to outcomes in PTA (Group 5: 52%; p>>0.05) but significantly higher than in Group 3 (0%; p=0.001) and Group 4 (20%; p=0.02). Induction immunosuppression was significantly associated with 5-year insulin independence (p=0.03), regardless of maintenance immunosuppression or other factors. These findings support potential for long-term insulin independence after ITA using potent induction therapy, with anti-CD3 Ab or TCDAb+TNF-α-i.
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DOI：
10.1016/j.clim.2009.04.007
发表时间：
2009-08
期刊：
Clinical immunology (Orlando, Fla.)
影响因子：
--
作者：
Herold KC;Gitelman S;Greenbaum C;Puck J;Hagopian W;Gottlieb P;Sayre P;Bianchine P;Wong E;Seyfert-Margolis V;Bourcier K;Bluestone JA;Immune Tolerance Network ITN007AI Study Group
通讯作者：
Immune Tolerance Network ITN007AI Study Group
影响因子：
8.8
作者：
Bellin, M. D.;Kandaswamy, R.;Hering, B. J.
通讯作者：
Hering, B. J.
DOI：
10.1073/pnas.89.8.3434
发表时间：
1992-04-15
影响因子：
11.1
作者：
MAKI, T;ICHIKAWA, T;PORTER, J
通讯作者：
PORTER, J
影响因子：
7.7
作者：
Robertson RP
通讯作者：
Robertson RP
影响因子：
8.8
作者：
Gurkan, S.;Luan, Y.;Murphy, B.
通讯作者：
Murphy, B.