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临床可用免疫抑制剂治疗的糖尿病非人灵长类中长期猪胰岛移植物存活。

Long-term porcine islet graft survival in diabetic non-human primates treated with clinically available immunosuppressants.

机构信息

Xenotransplantation Research Center, College of Medicine, Seoul National University, Seoul, Korea.

Department of Microbiology and Immunology, College of Medicine, Seoul National University, Seoul, Korea.

出版信息

Xenotransplantation. 2021 Mar;28(2):e12659. doi: 10.1111/xen.12659. Epub 2020 Nov 6.

Abstract

BACKGROUND

Although pancreatic islet transplantation is becoming an effective therapeutic option for patients with type 1 diabetes (T1D) who suffer from a substantially impaired awareness of hypoglycemia, its application is limited due to the lack of donors. Thus, pig-to-human islet xenotransplantation has been regarded as a promising alternative due to the unlimited number of "donor organs." Long-term xenogeneic islet graft survival in pig-to-non-human primate (NHP) models has mainly been achieved by administering the anti-CD154 mAb-based immunosuppressant regimen. Since the anti-CD154 mAb treatment has been associated with unexpected fatal thromboembolic complications in clinical trials, the establishment of a new immunosuppressant regimen that is able to be directly applied in clinical trials is an urgent need.

METHODS

We assessed an immunosuppressant regimen composed of clinically available agents at porcine islet transplantation in consecutive diabetic NHPs.

RESULTS

Porcine islet graft survival in consecutive diabetic NHPs (n = 7; >222, >200, 181, 89, 62, 55, and 34 days) without severe adverse events.

CONCLUSION

We believe that our study could contribute greatly to the initiation of islet xenotransplantation clinical trials.

摘要

背景

尽管胰岛移植术对于因严重低血糖感知障碍而罹患 1 型糖尿病(T1D)的患者而言,已成为一种有效的治疗选择,但由于供体缺乏,其应用受到限制。因此,猪到人的胰岛异种移植术已被视为一种很有前途的替代方法,因为它有无尽的“供体器官”。在猪到非人类灵长类动物(NHP)模型中,长期的异种胰岛移植物存活主要通过给予抗 CD154 mAb 为基础的免疫抑制剂方案来实现。由于抗 CD154 mAb 治疗与临床试验中意外致命的血栓栓塞并发症有关,因此迫切需要建立一种新的能够直接应用于临床试验的免疫抑制剂方案。

方法

我们评估了在连续糖尿病 NHP 中进行猪胰岛移植的由临床可用药物组成的免疫抑制剂方案。

结果

连续糖尿病 NHP 中的猪胰岛移植物存活(n=7;>222、>200、181、89、62、55 和 34 天),无严重不良事件。

结论

我们相信我们的研究将对胰岛异种移植临床试验的开展做出重大贡献。

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