Transplantation of human islets without immunosuppression

TLDR

Diabetes mellitus type 1 is an autoimmune disease that destroys insulin‑producing beta cells, and although beta‑cell replacement therapies have advanced, donor organ scarcity and the need for chronic immunosuppression limit their widespread use. The authors aim to demonstrate the clinical success of transplanting insulin‑producing islets using a bioartificial pancreas without requiring immune modulation. They employed a bioartificial pancreas device to transplant islets, thereby bypassing the host immune system and eliminating the need for immunosuppressive drugs. In a long‑standing type‑1 diabetic patient, the graft maintained persistent function and regulated insulin secretion without immune‑modulating medication, suggesting a safer, more scalable cell‑based therapy.

Abstract

Significance Diabetes mellitus type 1 is an autoimmune disease that results in irreversible destruction of insulin-producing beta cells. Substantial advances have been made in beta cell replacement therapies over the last decades. However, lack of eligible donor organs and the need for chronic immunosuppression to prevent rejection critically limit a widespread application of these strategies. In this paper we present the clinical success of using a bioartificial pancreas for the transplantation of insulin-producing islets without affecting the immune system. In a patient with long-standing type-1 diabetes we could demonstrate persistent graft function and regulated insulin secretion without the need for immune-modulating medication. This strategy opens up avenues for more widespread and safe application of various cell-based therapies.