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

Autor:	Verhoeff K; Department of Surgery, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta T6G 2R3, Canada., Marfil-Garza BA; National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Department of Medicine Division of Endocrinology, University of Alberta, and CHRISTUS-LatAm Hub-Excellence and Innovation Center, Monterrey, Mexico., Czarnecka Z; Department of Surgery, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta T6G 2R3, Canada., Cuesta-Gomez N; Department of Surgery, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta T6G 2R3, Canada., Jasra IT; Department of Surgery, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta T6G 2R3, Canada., Dadheech N; Department of Surgery, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta T6G 2R3, Canada., Senior PA; Clinical Islet Transplant Programme, Department of Medicine Division of Endocrinology, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta T6G 2R3, Canada., Shapiro AMJ; Department of Surgery, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta T6G 2R3, Canada.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2023 Oct 18; Vol. 108 (11), pp. 2772-2778.
DOI:	10.1210/clinem/dgad257
Abstrakt:	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. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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