Cutting edge of immune response and immunosuppressants in allogeneic and xenogeneic islet transplantation

• Published in: Frontiers in immunology Vol. 15; p. 1455691
• Main Authors: Yue, Liting, Li, Jisong, Yao, Mingjun, Song, Siyuan, Zhang, Xiaoqin, Wang, Yi
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 13.09.2024
• Subjects: allogenic and xenogenic islet transplantation; Animals; Graft Rejection - immunology; Graft Rejection - prevention & control; Graft Survival - drug effects; Graft Survival - immunology; Humans; immune response; immunosuppressants; Immunosuppressive Agents - therapeutic use; islet transplantation; Islets of Langerhans Transplantation - adverse effects; Islets of Langerhans Transplantation - immunology; Islets of Langerhans Transplantation - methods; Transplantation, Heterologous; Transplantation, Homologous; xenotransplantation; islet transplantation; xenotransplantation; allogenic and xenogenic islet transplantation; immune response; immunosuppressants
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2024.1455691

As an effective treatment for diabetes, islet transplantation has garnered significant attention and research in recent years. However, immune rejection and the toxicity of immunosuppressive drugs remain critical factors influencing the success of islet transplantation. While immunosuppressants are essential in reducing immune rejection reactions and can significantly improve the survival rate of islet transplants, improper use of these drugs can markedly increase mortality rates following transplantation. Additionally, the current availability of islet organ donations fails to meet the demand for organ transplants, making xenotransplantation a crucial method for addressing organ shortages. This review will cover the following three aspects: 1) the immune responses occurring during allogeneic islet transplantation, including three stages: inflammation and IBMIR, allogeneic immune response, and autoimmune recurrence; 2) commonly used immunosuppressants in allogeneic islet transplantation, including calcineurin inhibitors (Cyclosporine A, Tacrolimus), mycophenolate mofetil, glucocorticoids, and Bortezomib; and 3) early and late immune responses in xenogeneic islet transplantation and the immune effects of triple therapy (ECDI-fixed donor spleen cells (ECDI-SP) + anti-CD20 + Sirolimus) on xenotransplantation.