A New Immunosuppression Option Shows Promise for Islet Transplants in Type 1 Diabetes

For people with Type 1 diabetes who receive islet cell transplants—whether from donor pancreases or grown from stem cells in the lab—the immune system poses a major challenge. The body naturally attacks foreign cells, so transplant recipients must take immunosuppressive medications to prevent rejection. However, drugs like tacrolimus, commonly used for this purpose, carry significant risks including kidney damage and neurological problems.

Tegoprubart (AT-1501) is an anti-CD40L antibody developed by Eledon Pharmaceuticals. It works differently than traditional immunosuppressants and has already shown promising safety and effectiveness in kidney transplant patients. Now, researchers at the University of Chicago, led by Dr. Piotr Witkowski, are investigating whether tegoprubart could offer a less toxic path forward for islet transplant recipients.

The ongoing islet replacement trial has published preliminary data on six subjects who received cadaveric donor islet transplants with tegoprubart as their immunosuppressive agent. The results are encouraging. All six transplant recipients achieved marked improvements in blood sugar control and reached insulin independence—meaning they no longer needed insulin injections—after receiving one or two islet transplants.

Importantly, tegoprubart was generally well tolerated across the group. No serious adverse events were reported, and critically, the researchers observed no signs of kidney or neurological toxicity, the complications that commonly occur with traditional immunosuppression regimens. These early findings suggest the drug may allow transplant recipients to avoid some of the most serious medication side effects while maintaining transplant success.

Islet transplantation remains a specialized procedure available to a limited number of people with Type 1 diabetes, partly because the need for lifelong immunosuppression brings its own health burden. If tegoprubart continues to demonstrate safety and effectiveness in larger, longer-term studies, it could help expand who might benefit from this approach by making the treatment itself safer and more tolerable.

This trial is supported by Breakthrough T1D International and Eledon Pharmaceuticals. As with all early-stage clinical research, these promising preliminary results will need to be confirmed with more subjects and longer follow-up before tegoprubart becomes standard care. If you're interested in learning about islet transplantation trials or other Type 1 diabetes research you might participate in, Breakthrough T1D's Clinical Trial Finder is a resource to explore actively recruiting studies.

Origin: breakthrought1d.ca (News report). Evidence: News report, corroborated with 3 indexed studies. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.