Chapter

The Islets of Langerhans

Volume 654 of the series Advances in Experimental Medicine and Biology pp 725-747

Date:

Modulation of Early Inflammatory Reactions to Promote Engraftment and Function of Transplanted Pancreatic Islets in Autoimmune Diabetes

  • Lorenzo PiemontiAffiliated withSan Raffaele Diabetes Research Institute (HSR-DRI) Email author 
  • , Luca G. GuidottiAffiliated withSan Raffaele Diabetes Research Institute (HSR-DRI)
  • , Manuela BattagliaAffiliated withSan Raffaele Diabetes Research Institute (HSR-DRI)

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Abstract

We acknowledge that successful long-term islet survival in the liver and immune tolerance to intrahepatic islet antigens are highly dependent upon the initial inflammatory and priming events that occur at this site. Thromboembolic and necroinflammatory events occurring in the liver early after portal vein islet transplantation are thought to reduce the total islet mass by up to 75%. The magnitude of such loss represents a major factor necessitating the extremely large number of islets needed to achieve normoglycemia. A better understanding and control of these events – including their likely support to effector immune responses – are required if we are to develop ways to prevent them, improve intrahepatic islet engraftment, and achieve long-term tolerance.

Keywords

Type 1 diabetes Pancreatic islet transplantation Instant blood-mediated inflammatory reaction