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Journal of Transplantation
Volume 2011, Article ID 637692, 24 pages
http://dx.doi.org/10.1155/2011/637692
Review Article

Current Status of Immunomodulatory and Cellular Therapies in Preclinical and Clinical Islet Transplantation

1Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA
2Division of Transplantation, Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA
3The Center for Cellular Transplantation and Therapeutics, University of Virginia, Charlottesville, VA 22908, USA

Received 1 May 2011; Accepted 11 July 2011

Academic Editor: Antonello Pileggi

Copyright © 2011 Preeti Chhabra and Kenneth L. Brayman. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Clinical islet transplantation is a 𝛽 -cell replacement strategy that represents a possible definitive intervention for patients with type 1 diabetes, offering substantial benefits in terms of lowering daily insulin requirements and reducing incidences of debilitating hypoglycemic episodes and unawareness. Despite impressive advances in this field, a limiting supply of islets, inadequate means for preventing islet rejection, and the deleterious diabetogenic and nephrotoxic side effects associated with chronic immunosuppressive therapy preclude its wide-spread applicability. Islet transplantation however allows a window of opportunity for attempting various therapeutic manipulations of islets prior to transplantation aimed at achieving superior transplant outcomes. In this paper, we will focus on the current status of various immunosuppressive and cellular therapies that promote graft function and survival in preclinical and clinical islet transplantation with special emphasis on the tolerance-inducing capacity of regulatory T cells as well as the 𝛽 -cells regenerative capacity of stem cells.