Current status and future of clinical islet xenotransplantation

• Published in: Journal of diabetes 2016-07, Vol.8 (4), p.483-493
• Main Authors: Matsumoto, Shinichi, Tomiya, Masayuki, Sawamoto, Osamu
• Format: Article
• Language: English
• Subjects: Animals; Diabetes Mellitus, Type 1 - surgery; encapsulation; Forecasting; Humans; International Xenotransplantation Association consensus statement; islet xenotransplantation; Islets of Langerhans Transplantation - methods; Islets of Langerhans Transplantation - trends; porcine endogenous retrovirus; porcine islets; Risk Factors; Swine; Tissue Donors - statistics & numerical data; Transplantation, Heterologous; Transplantation, Homologous; Xenotransplantation; 国际异种移植协会共识声明; 封装; 异种胰岛移植; 猪内源性逆转录病毒; 猪胰岛
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.12395

β‐Cell replacement therapy, including allogeneic pancreas and islet transplantation, can normalize HbA1c levels in unstable type 1 diabetic (T1D) patients, but a donor shortage is a serious issue. To overcome this problem, xenotransplantation is an attractive option. In fact, islet transplantation from porcine pancreata was performed in the 1990s, which opened the door for islet xenotransplantation, but the possibility of porcine endogenous retrovirus (PERV) infection was raised, which has restricted progress in this field. The International Xenotransplantation Association published a consensus statement on conditions for undertaking clinical trials of porcine islet products in T1D to restart islet xenotransplantation safely. Clinical porcine islet xenotransplantation was restarted under comprehensive regulations in New Zealand. In addition, newly emerged gene‐editing technologies have activated the xenotransplantation field. Islet xenotransplantation is becoming a clinical reality, with the results of recent studies showing promise to advance this field. 摘要 β细胞补充治疗,包括同种异体胰腺与胰岛移植,对于脆性1型糖尿病患者来说可使其HbA1c水平正常化,但是供体短缺是个严重的问题。为了克服这个问题,异种移植是一种吸引人的备选方法。实际上,在上世纪90年代就已经有人使用猪胰腺进行了胰岛移植,这为我们打开了异种胰岛移植的大门,但是感染猪内源性逆转录病毒的可能性增加了,导致这个领域的进展受到了限制。国际异种移植协会发表了一份有关在1型糖尿病患者中重新开始安全使用猪胰岛产品进行异种胰岛移植临床试验所需条件的共识声明。遵照新西兰综合法规,临床上重新开始了猪胰岛的异种移植。另外,新近出现的基因剪辑技术也使得异种移植领域更加活跃。异种胰岛移植正在变成临床现实,最近的研究结果显示这个领域大有前途。