Editorial for Special Issue “Islet Transplantation”

Abstract

Full text

Islet cell transplantation is revolutionary. Given recent developments, diabetes no longer seems incurable. Human islet cells have been approved by the FDA in the form of a drug named Lantidra^TM^, representing a breakthrough treatment for type 1 diabetes with severe hypoglycemia [1]. Clinical trials of embryonic stem cell (ESC)-derived islet transplantation have also been successful [2]. However, deriving ESCs from human fertilized eggs brings ethical issues [3]. To avoid this ethical issue, clinical trials of inducible pluripotent stem cell (iPS)-derived islet transplantation have been initiated in Asia, including in Japan [4].

The next major issue is the necessity of immunosuppressive drugs.

A clinical trial of encapsulated porcine islet xenotransplantation without immunosuppressive drugs has been initiated in the USA [5]. In Argentina, patients’ opinions 10 years after receiving encapsulated porcine islet xenotransplantation were very favorable [6], and similar outcomes are anticipated in the US clinical trial.

The ultimate goal of islet transplantation should be to enable type 1 diabetic patients to become insulin-independent without the need for life-long immunosuppressive drugs.

This goal can be achieved by inducing immunological tolerance and/or improving the efficacy of encapsulated islet xenotransplantation. Continuous research into islet cell transplantation will be important for achieving this goal.