Journal
DIABETES
Volume 63, Issue 1, Pages 12-19Publisher
AMER DIABETES ASSOC
DOI: 10.2337/db12-0364
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Funding
- Canadian Institutes of Health Research [MOP-123338, MOP-14862] Funding Source: Medline
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beta-Cell replacement by islet transplantation is a potential curative therapy for type 1 diabetes. Despite advancements in islet procurement and immune suppression that have increased islet transplant survival, graft function progressively declines, and many recipients return to insulin dependence within a few years posttransplant. The progressive loss of -cell function in islet transplants seems unlikely to be explained by allo- and autoimmune-mediated mechanisms alone and in a number of ways resembles -cell failure in type 2 diabetes. That is, both following transplantation and in type 2 diabetes, islets exhibit decreased first-phase glucose-stimulated insulin secretion, impaired proinsulin processing, inflammation, formation of islet amyloid, signs of oxidative and endoplasmic reticulum stress, and -cell death. These similarities suggest common mechanisms may underlie loss of insulin production in both type 2 diabetes and islet transplantation and point to the potential for therapeutic approaches used in type 2 diabetes that target the -cell, such as incretin-based therapies, as adjuncts for immunosuppression in islet transplantation.
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