Stem Cell-Derived Islet Transplantation in Patients With Type 2 Diabetes : Can Diabetes Subtypes Guide Implementation?

© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..

Historically, only patients with brittle diabetes or severe recurrent hypoglycemia have been considered for islet transplantation (ITx). This population has been selected to optimize the risk-benefit profile, considering risks of long-term immunosuppression and limited organ supply. However, with the advent of stem cell (SC)-derived ITx and the potential for immunosuppression-free ITx, consideration of a broader recipient cohort may soon be justified. Simultaneously, the classical categorization of diabetes is being challenged by growing evidence in support of a clustering of disease subtypes that can be better categorized by the All New Diabetics in Scania (ANDIS) classification system. Using the ANDIS classification, 5 subtypes of diabetes have been described, each with unique causes and consequences. We evaluate consideration for ITx in the context of this broader patient population and the new classification of diabetes subtypes. In this review, we evaluate considerations for ITx based on novel diabetes subtypes, including their limitations, and we elaborate on unique transplant features that should now be considered to enable ITx in these "unconventional" patient cohorts. Based on evidence from those receiving whole pancreas transplant and our more than 20-year experience with ITx, we offer recommendations and potential research avenues to justify implementation of SC-derived ITx in broader populations of patients with all types of diabetes.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:108

Enthalten in:

The Journal of clinical endocrinology and metabolism - 108(2023), 11 vom: 18. Okt., Seite 2772-2778

Sprache:

Englisch

Beteiligte Personen:

Verhoeff, Kevin [VerfasserIn]
Marfil-Garza, Braulio A [VerfasserIn]
Czarnecka, Zofia [VerfasserIn]
Cuesta-Gomez, Nerea [VerfasserIn]
Jasra, Ila Tewari [VerfasserIn]
Dadheech, Nidheesh [VerfasserIn]
Senior, Peter A [VerfasserIn]
Shapiro, A M James [VerfasserIn]

Links:

Volltext

Themen:

Diabetes
Differentiation
Inducible pluripotent stem cells
Islet transplantation
Journal Article
Research Support, Non-U.S. Gov't
Review

Anmerkungen:

Date Completed 23.10.2023

Date Revised 24.10.2023

published: Print

Citation Status MEDLINE

doi:

10.1210/clinem/dgad257

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM356736547