Role of immune tolerance
Induction of immune tolerance represents another intriguing approach. Dr. Garweg cited research in which islet cells were transplanted in the anterior chamber of the eye.
“These cells showed good survival and were well tolerated under topical corticosteroids,” he said. “During early follow-up, the treated patient had improvement in c-peptide and blood glucose.
“It is hoped that this approach might induce immune tolerance to systemically transplanted islet cells and result in a new endogenous source of insulin production with an improvement in the outcome of diabetes and better control of diabetic retinopathy,” Dr. Garweg added.
Similarly, it was reported in an animal model that interphotoreceptor-binding protein injection into the anterior chamber induced immune tolerance and prevented progression of diabetic retinopathy.
“The treatment did not prevent systemic diabetic organ damage, however,” Dr. Garweg pointed out. “Therefore, the future will depend on intensified interdisciplinary networking to develop combination local and systemic therapeutic strategies.”