Impact of GAD65 and IA2 autoantibodies on islet allograft survival

Autor: Joana R. N. Lemos, Raffaella Poggioli, Jonathan Ambut, Nujen C. Bozkurt, Ana M. Alvarez, Nathalia Padilla, Francesco Vendrame, Camillo Ricordi, David A. Baidal, Rodolfo Alejandro
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Clinical Diabetes and Healthcare, Vol 4 (2023)
Druh dokumentu: article
ISSN: 2673-6616
DOI: 10.3389/fcdhc.2023.1269758
Popis: IntroductionIslet transplantation (ITx) shows promise in treating T1D, but the role of islet autoantibodies on graft survival has not been clearly elucidated. We aimed to analyze the effect of GAD65 and IA2 autoantibody status on graft survival and attainment of insulin independence in subjects with T1D who underwent ITx.MethodWe conducted a retrospective cohort study on 47 ITx recipients from 2000 to 2018. Islet infusion was performed via intrahepatic portal (n=44) or onto the omentum via laparoscopic approach (n=3). Immunosuppression involved anti-IL2 receptor antibody, anti-TNF, and dual combinations of sirolimus, tacrolimus, or mycophenolate mofetil (Edmonton-like) in 38 subjects (80.9%). T-cell depletion induction with Edmonton-like maintenance was used in 9 subjects (19%). GAD65 and IA2 autoantibodies were assessed pre-transplant and post-transplant (monthly) until graft failure, and categorized as persistently negative, persistently positive, or seroconverters. Graft survival was analyzed using U-Mann-Whitney test, and Quade’s nonparametric ANCOVA adjusted for confounders. Kaplan-Meier and Log-Rank tests were employed to analyze attainment of insulin independence. P value
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