Dr Camillo Ricordi Reflects on Next Steps for T1D Islet Transplantation

Camillo Ricordi, MD, FNAI, outlines what needs to happen next in the islet transplantation field.

Several preclinical models exist that demonstrate induction of local immunosuppression, said Camillo Ricordi, MD, FNAI, a professor and director of the Diabetes Research Institute and Cell Transplant Center at the University of Miami, Florida.


What are the next steps for research into islet transplantation for type 1 diabetes?

The next step will be to continue to try to define strategies that will use less immunosuppression and tolerance induction. There are several preclinical models that are extremely promising both inducing local immunosuppression, local immunomodulation, at the site of transplantation, [and] working on models, like we started doing clinically, putting islets in [inaudible] instead of the liver that provide a confined space that you can manipulate. Also as far as tissue engineering with immunomodulatory molecules, you can use these trials combining mesenchymal stem cells, which are also immunomodulator and anti-inflammatory. And you will see a trial with regulatory T cells expanded to block progression of autoimmunity but also to help to induce transplant tolerance.

These are on one front. One front will be immunomodulation and tolerance induction in the absence of chronic recipient immunosuppression. And on the other side will be defining better and improved sources of stem cell–derived insulin-producing cells to provide enough supply to transplant all the patients who may benefit from these procedures.