TY - JOUR
T1 - Type 1 Diabetes Recurrence After Simultaneous Pancreas-Kidney Transplantation
AU - Burke, George W.
AU - Ciancio, Gaetano
AU - Morsi, Mahmoud
AU - Figueiro, Jose
AU - Chen, Linda
AU - Vendrame, Francesco
AU - Pugliese, Alberto
N1 - Funding Information:
The authors wish to acknowledge the John C. Hench Foundation for supporting this research in type 1 diabetes recurrence after simultaneous kidney-pancreas transplantation.
Publisher Copyright:
© 2018, Springer Nature Switzerland AG.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Purpose of Review: Simultaneous pancreas-kidney transplantation (SPKT) is an importantoption for patients with type 1 diabetes (T1D) and end-stage renal disease.While most SPKT recipients experience long-term euglycemia, about 5% return toinsulin therapy, 5–20 years after transplantation due to T1D recurrence (T1DR).Over the last two decades, we have assessed autoimmunity in our patients,evaluating autoantibodies (GAD65, IA2, and ZnT8), autoreactive T cells, andpancreas transplant biopsies. Recent Findings: Most patients demonstrate seroconversion for multipleautoantibodies. Autoreactive memory T cells have been identified in theperipheral blood, pancreas transplant, and peri-pancreas transplant tissues.Biopsies generally exhibit insulitis, the typical lesion of T1D, affectingpancreatic islets in the pancreas transplant, and lack of rejection in thepancreas and kidney transplants. Summary: In addition to membrane expression of memory markers, we haveidentified other biomarkers, including CXCR3, on circulating and infiltratingautoreactive memory T cells. We hope that this work will lead to therapeuticintervention in our patients with T1DR, and that this will translate toeffective treatment for T1D.
AB - Purpose of Review: Simultaneous pancreas-kidney transplantation (SPKT) is an importantoption for patients with type 1 diabetes (T1D) and end-stage renal disease.While most SPKT recipients experience long-term euglycemia, about 5% return toinsulin therapy, 5–20 years after transplantation due to T1D recurrence (T1DR).Over the last two decades, we have assessed autoimmunity in our patients,evaluating autoantibodies (GAD65, IA2, and ZnT8), autoreactive T cells, andpancreas transplant biopsies. Recent Findings: Most patients demonstrate seroconversion for multipleautoantibodies. Autoreactive memory T cells have been identified in theperipheral blood, pancreas transplant, and peri-pancreas transplant tissues.Biopsies generally exhibit insulitis, the typical lesion of T1D, affectingpancreatic islets in the pancreas transplant, and lack of rejection in thepancreas and kidney transplants. Summary: In addition to membrane expression of memory markers, we haveidentified other biomarkers, including CXCR3, on circulating and infiltratingautoreactive memory T cells. We hope that this work will lead to therapeuticintervention in our patients with T1DR, and that this will translate toeffective treatment for T1D.
KW - Autoantibodies
KW - Autoimmunity
KW - Autoreactive T cells
KW - Memory T cells
KW - Pancreas transplant
KW - Type 1 diabetes
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U2 - 10.1007/s40472-018-0210-0
DO - 10.1007/s40472-018-0210-0
M3 - Review article
AN - SCOPUS:85090086240
VL - 5
SP - 295
EP - 303
JO - Current Transplantation Reports
JF - Current Transplantation Reports
SN - 2196-3029
IS - 4
ER -
