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While tests are available to determine whether or not a transplanted organ, such as a kidney, is being tolerated by the recipient’s immune system or is being rejected, there is no current method to detect early immune activity that can lead to the rejection of the transplanted islets.
Currently, the only indication of islet loss is elevated blood sugars and increased insulin requirements.
By the time this occurs, many of the islets have already been destroyed and the remaining cells will be over-worked and eventually die.
Predicting Islet Loss
By identifying markers that indicate or predict if the transplant is losing function or under attack, timely intervention can often preserve the transplant.
DRI scientists have discovered that loss of islet function in patients was preceded by prolonged elevation of specific immune system markers in their blood. This occurred several weeks before blood sugars began to rise. In contrast, patients who maintained normal glucose control had no evidence of these markers.
Further studies and the development of specific tests to establish more precise measurements are under way.
Recurrence of Autoimmunity
The possible reactivation of the immune cells that caused diabetes, or recurrence of autoimmunity, may affect the long-term outcome of islet and pancreas transplants.
The DRI has developed a multidisciplinary, integrated approach to actively monitor autoimmune responses in patients who have received islets or pancreas transplants.
Through these studies, investigators can assess the potential impact of recurrence of autoimmunity on long-term outcome of the transplants, as well as the need and nature of additional interventions to protect the insulin-producing cells. Improved immune monitoring is key to the long-term success of islet cell transplantation.
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