For as long as tissues and organs have been transplanted from one person to another, doctors have had to deal with a persistent problem: rejection. Our immune system is designed to attack foreign invaders, and tissue from another person is the ultimate foreign body. To deal with this problem, the medical community has long relied on anti-rejection drugs that suppress the immune system.
But anti-rejection drugs work at a significant cost. Because they suppress the immune system, they increase the risk of serious infections and cancer. They can also have other serious side effects, and they tend to become less effective over time. These risks are one reason why pancreatic islet cell transplantation — implanting insulin-producing cells from a donor — hasn’t been a mainstream option for treating type 1 diabetes.
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But now, researchers at the University of Minnesota have shown that in non-human primates, it’s possible to achieve long-term survival of transplanted islet cells without ongoing use of anti-rejection drugs. This is the final preclinical step before starting human trials of the technique the researchers used.
To prevent rejection of donor islet cells, the researchers infused a modified version of white blood cells from the donor into the recipient one week before, and then one day after, the islet cell transplant. This mimics a natural process in the body for maintaining tolerance of your own tissues and organs.
The researchers initially gave the islet cell recipients anti-rejection drugs, which were tapered off and discontinued completely 21 days after the transplant. Despite the lack of anti-rejection drugs going forward, the recipients showed long-term survival and function of the transplanted insulin-producing islet cells.
If human trials confirm the safety and effectiveness of this process, it could bring islet cell transplantation one step closer to being a long-term treatment or even cure for type 1 diabetes.
A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.