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Goutchtat R, Quenon A, Clarisse M, Delalleau N, Coddeville A, Gobert M, Gmyr V, Kerr-Conte J, Pattou F, Hubert T. Effects of subtotal pancreatectomy and long-term glucose and lipid overload on insulin secretion and glucose homeostasis in minipigs. Endocrinol Diabetes Metab 2023:e425. [PMID: 37144278 DOI: 10.1002/edm2.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Nowadays, there are no strong diabetic pig models, yet they are required for various types of diabetes research. Using cutting-edge techniques, we attempted to develop a type 2 diabetic minipig model in this study by combining a partial pancreatectomy (Px) with an energetic overload administered either orally or parenterally. METHODS Different groups of minipigs, including Göttingen-like (GL, n = 17) and Ossabaw (O, n = 4), were developed. Prior to and following each intervention, metabolic assessments were conducted. First, the metabolic responses of the Göttingen-like (n = 3) and Ossabaw (n = 4) strains to a 2-month High-Fat, High-Sucrose diet (HFHSD) were compared. Then, other groups of GL minipigs were established: with a single Px (n = 10), a Px combined with a 2-month HFHSD (n = 6), and long-term intraportal glucose and lipid infusions that were either preceded by a Px (n = 4) or not (n = 4). RESULTS After the 2-month HFHSD, there was no discernible change between the GL and O minipigs. The pancreatectomized group in GL minipigs showed a significantly lower Acute Insulin Response (AIR) (18.3 ± 10.0 IU/mL after Px vs. 34.9 ± 13.7 IU/mL before, p < .0005). In both long-term intraportal infusion groups, an increase in the Insulinogenic (IGI) and Hepatic Insulin Resistance Indexes (HIRI) was found with a decrease in the AIR, especially in the pancreatectomized group (IGI: 4.2 ± 1.9 after vs. 1.5 ± 0.8 before, p < .05; HIRI (×10-5 ): 12.6 ± 7.9 after vs. 3.8 ± 4.3 before, p < .05; AIR: 24.4 ± 13.7 µIU/mL after vs. 43.9 ± 14.5 µIU/mL before, p < .005). Regardless of the group, there was no fasting hyperglycemia. CONCLUSIONS In this study, we used pancreatectomy followed by long-term intraportal glucose and lipid infusions to develop an original minipig model with metabolic syndrome and early signs of glucose intolerance. We reaffirm the pig's usefulness as a preclinical model for the metabolic syndrome but without the fasting hyperglycemia that characterizes diabetes mellitus.
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Affiliation(s)
- Rébecca Goutchtat
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
| | - Audrey Quenon
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
- Univ. Lille, CHU Lille, UFR3S, Département Hospitalo-Universitaire de Recherche et d'Enseignement (Dhure), Lille, France
| | | | - Nathalie Delalleau
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
| | - Anaïs Coddeville
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
| | - Mathilde Gobert
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
| | - Valéry Gmyr
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
| | - Julie Kerr-Conte
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
| | - François Pattou
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
| | - Thomas Hubert
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, UFR3S, U1190 - Egid, Lille, France
- Univ. Lille, CHU Lille, UFR3S, Département Hospitalo-Universitaire de Recherche et d'Enseignement (Dhure), Lille, France
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Lundberg R, Beilman GJ, Dunn TB, Pruett TL, Chinnakotla SC, Radosevich DM, Robertson RP, Ptacek P, Balamurugan A, Wilhelm JJ, Hering BJ, Sutherland DE, Moran A, Bellin MD. Metabolic assessment prior to total pancreatectomy and islet autotransplant: utility, limitations and potential. Am J Transplant 2013; 13:2664-71. [PMID: 23924045 PMCID: PMC3805695 DOI: 10.1111/ajt.12392] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 05/24/2013] [Accepted: 06/13/2013] [Indexed: 01/25/2023]
Abstract
Islet autotransplant (IAT) may ameliorate postsurgical diabetes following total pancreatectomy (TP), but outcomes are dependent upon islet mass, which is unknown prior to pancreatectomy. We evaluated whether preoperative metabolic testing could predict islet isolation outcomes and thus improve assessment of TPIAT candidates. We examined the relationship between measures from frequent sample IV glucose tolerance tests (FSIVGTT) and mixed meal tolerance tests (MMTT) and islet mass in 60 adult patients, with multivariate logistic regression modeling to identify predictors of islet mass ≥2500 IEQ/kg. The acute C-peptide response to glucose (ACRglu) and disposition index from FSIVGTT correlated modestly with the islet equivalents per kilogram body weight (IEQ/kg). Fasting and MMTT glucose levels and HbA1c correlated inversely with IEQ/kg (r values -0.33 to -0.40, p ≤ 0.05). In multivariate logistic regression modeling, normal fasting glucose (<100 mg/dL) and stimulated C-peptide on MMTT ≥4 ng/mL were associated with greater odds of receiving an islet mass ≥2500 IEQ/kg (OR 0.93 for fasting glucose, CI 0.87-1.0; OR 7.9 for C-peptide, CI 1.75-35.6). In conclusion, parameters obtained from FSIVGTT correlate modestly with islet isolation outcomes. Stimulated C-peptide ≥4 ng/mL on MMTT conveyed eight times the odds of receiving ≥2500 IEQ/kg, a threshold associated with reasonable metabolic control postoperatively.
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Affiliation(s)
- Rachel Lundberg
- Department of Surgery, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN,Department of Pediatrics, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Gregory J. Beilman
- Department of Surgery, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Ty B. Dunn
- Department of Surgery, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Timothy L. Pruett
- Department of Surgery, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Srinath C. Chinnakotla
- Department of Surgery, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - David M. Radosevich
- Department of Surgery, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | | | - Peggy Ptacek
- Department of Pediatrics, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN,Schulze Diabetes Institute University of Minnesota and University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - A.N. Balamurugan
- Schulze Diabetes Institute University of Minnesota and University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Joshua J. Wilhelm
- Schulze Diabetes Institute University of Minnesota and University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Bernhard J. Hering
- Schulze Diabetes Institute University of Minnesota and University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - David E.R. Sutherland
- Schulze Diabetes Institute University of Minnesota and University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Antoinette Moran
- Department of Pediatrics, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
| | - Melena D. Bellin
- Department of Pediatrics, University of Minnesota Amplatz Children’s Hospital Minneapolis, MN,Schulze Diabetes Institute University of Minnesota and University of Minnesota Amplatz Children’s Hospital Minneapolis, MN
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Sterkers A, Hubert T, Gmyr V, Torres F, Baud G, Delalleau N, Vantyghem MC, Kerr-Conte J, Caiazzo R, Pattou F. Islet survival and function following intramuscular autotransplantation in the minipig. Am J Transplant 2013; 13:891-898. [PMID: 23496914 DOI: 10.1111/ajt.12136] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 10/22/2012] [Accepted: 11/05/2012] [Indexed: 01/25/2023]
Abstract
The liver may not be an optimal site for islet transplantation due to obstacles by an instant blood-mediated inflammatory response (IBMIR), and low revascularization of transplanted islets. Therefore, intramuscular islet transplantation (IMIT) offers an attractive alternative, based on its simplicity, enabling easier access for noninvasive graft imaging and cell explantation. In this study, we explored the outcome of autologous IMIT in the minipig (n = 30). Using the intramuscular injection technique, we demonstrated by direct histological evidence the rapid revascularization of islets autotransplanted into the gracilius muscle. Islet survival assessment was performed using immunohistochemistry staining for insulin and glucagon up to a period of 6 months. Furthermore, we showed the crucial role of minimizing mechanical trauma to the myofibers and limiting exocrine contamination. Intramuscular islet graft function after transplantation was confirmed by documenting the acute insulin response to intravenous glucose in 5/11 pancreatectomized animals. Graft function after IMIT remained however significantly lower than the function measured in 12 out of 18 minipigs who received a similar islet volume in the liver through intraportal infusion. Collectively, these results demonstrated in a clinically relevant preclinical model, suggest IMIT as a promising alternative to intraportal infusion for the transplantation of β cells in certain medical situations.
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Affiliation(s)
- A Sterkers
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France.,General and Endocrine surgery, CHRU, Lille, 59000 Lille, France
| | - T Hubert
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France
| | - V Gmyr
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France
| | - F Torres
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France.,General and Endocrine surgery, CHRU, Lille, 59000 Lille, France
| | - G Baud
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France.,General and Endocrine surgery, CHRU, Lille, 59000 Lille, France
| | - N Delalleau
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France
| | - M C Vantyghem
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France.,Endocrinology and metabolism, CHRU, Lille, 59000 Lille, France
| | - J Kerr-Conte
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France
| | - R Caiazzo
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France.,General and Endocrine surgery, CHRU, Lille, 59000 Lille, France
| | - F Pattou
- UMR 859 Biotherapies for diabetes, INSERM, 59000 Lille, France.,UDSL, University of Lille Nord de, France, 59000 Lille, France.,General and Endocrine surgery, CHRU, Lille, 59000 Lille, France.,European Genomic Institute for Diabetes (EGID), FR 3508, 59000 Lille, France
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Hawthorne WJ, Simond DM, Stokes R, Patel AT, Walters S, Burgess J, O'Connell PJ. Pre-clinical model of composite foetal pig pancreas fragment/renal xenotransplantation to treat renal failure and diabetes. Xenotransplantation 2012; 18:390-9. [PMID: 22168145 DOI: 10.1111/j.1399-3089.2011.00681.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED BACKGROUND Development of a limitless source of β cells for xenotransplantation into patients suffering type 1 diabetes and renal failure that can control their diabetes and provide normal renal function in one procedure would be a major achievement. For the islet tissue to survive transplantation, as an islet-kidney composite graft this would have significant advantages. It would simplify the surgical procedure; remove the complications caused by the exocrine pancreas whilst reversing diabetes and uraemia. It was our hypothesis that a composite foetal porcine pancreas fragment (FPPF)/renal graft could achieve these objectives in a large pre-clinical animal model as a means to establish whether this would be feasible before moving to the clinic. METHODS Inbred 'Westran' pig FPPF were transplanted under the kidney capsule of syngeneic Westran pig recipients without immunosuppression. Following maturation of the FPPF under the renal subcapsular space of this recipient, this kidney bearing the composite FPPF piggyback graft was removed and transplanted into another nephrectomized and pancreatectomized recipient to demonstrate function. RESULTS Under the kidney capsule of the first transplant group (n = 6), the FPPF-transplanted tissue developed and matured to form islet cell nests. These composite FPPF/renal grafts were then successfully removed and transplanted into the second functional assessment recipient group. This second group of six composite FPPF/renal-grafted pigs had normal renal function for more than 44 days and normal glucose homoeostasis without exogenous insulin as assessed by normal glucose tolerance tests, K values and normal glucagon secretion. Histological analysis showed despite the ischaemic insult during the composite kidney transplant procedure, there was appropriate development of islet-like structures up to and beyond 224 days after the original transplantation under the kidney capsule. CONCLUSIONS This study shows that the use of composite FPPF/renal grafts can cure both diabetes and renal failure with a single-transplant procedure. Using such composite grafts for xenotransplantation would simplify the surgical procedure and protect the islet graft from the immediate innate immune response.
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Affiliation(s)
- Wayne J Hawthorne
- Centre for Transplant & Renal Research, Westmead Millennium Research Institute, University of Sydney, Westmead, NSW, Australia.
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Kim HI, Lee SY, Jin SM, Kim KS, Yu JE, Yeom SC, Yoon TW, Kim JH, Ha J, Park CG, Kim SJ. Parameters for successful pig islet isolation as determined using 68 specific-pathogen-free miniature pigs. Xenotransplantation 2009; 16:11-8. [PMID: 19243556 DOI: 10.1111/j.1399-3089.2008.00504.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Islet cell transplantation is a novel therapeutic modality for the cure of diabetes. Pig islet cells are an attractive substitute for human islet cells; however, they are known to be particularly difficult to isolate because of a weak islet capsule and a tendency to be fragmented during enzymatic digestion. Therefore, parameters favoring successful pig islet isolation were investigated using specific-pathogen-free (SPF) miniature pigs. METHODS Sixty-eight SPF miniature pigs were used for islet isolation. Birth weight, body weight, age, sex, pregnancy history, and the fasting blood glucose levels of each pig were determined. Each pig's general condition was assessed with regard to feeding status and physical activity. Pancreas procurement was performed by one surgical team. Anesthesia duration, operation duration, procedure quality, and perfusate type were recorded. After pancreatectomy, a biopsy was performed for islet density analysis. Decapsulation, cannulation duration, degree of distension, and cold ischemic time were assessed. During islet isolation, pancreas weight, digestion time, and digested tissue proportion were recorded. Isolation results were evaluated by total islet equivalents (IEQ), islet equivalents per gram of pancreas (IEQ/g), isolation index, islet recovery rate, purity, and visual grade. To identify the predictors of higher islet isolation yield, we performed binary logistic regression analysis with significant (P < 0.05) variables from the univariate analysis. RESULTS The pigs were categorized into high (n = 34) and low yield (n = 34) groups according to the median IEQ/g or total IEQ values. Body weight and age were significantly different between the two groups. Being male or a positive history of pregnancy in females was factors favoring successful islet isolation. General condition assessments failed to estimate islet isolation results. Long anesthesia duration, which might have caused ischemic injury to the pancreas, negatively affected islet isolation results. Decapsulation, cannulation duration, and subsequent pancreas distension were significantly important in successful islet isolation. Inter-lot variability of Liberase was not observed because of screening processes performed before purchase. Isolation index and islet recovery rate correlated well with islet yields. CONCLUSIONS Multivariate analysis using total IEQ and IEQ/g as outcome variables indicated that age older than 2, being male and moderate distension by Liberase injection are major determinants influencing successful islet isolation.
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Affiliation(s)
- Hyoung-Il Kim
- Xenotransplantation Research Center, Jongno-gu, Seoul, Korea
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7
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Hubert T, Gmyr V, Vantyghem MC, Kerr-Conte J, Pattou F. Predicting the outcome of islet isolation in large mammals. Diabetologia 2009; 52:177-8; author reply 179-80. [PMID: 19023559 DOI: 10.1007/s00125-008-1198-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 09/27/2008] [Indexed: 11/26/2022]
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Hubert T, Strecker G, Gmyr V, Arnalsteen L, Garrigue D, Ezzouaoui R, Caiazzo R, Dezfoulian G, Averland B, Vandewalle B, Vantyghem MC, Kerr-Conte J, Pattou F. Acute insulin response to arginine in deceased donors predicts the outcome of human islet isolation. Am J Transplant 2008; 8:872-6. [PMID: 18261179 DOI: 10.1111/j.1600-6143.2007.02131.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Despite a stringent donor selection, human islet isolation remains frustratingly unpredictable. In this study, we measured acute insulin response to arginine (AIRarg), an in vivo surrogate measure of islet mass, in 29 human deceased donors before organ donation, and correlated values with the outcome of islet isolation. Thirteen isolations (45%) met the threshold for clinical islet transplantation. Among all measured donor characteristics, the only discriminating variable between successful or unsuccessful isolations was donor AIRarg (p < 0.01). Using a threshold of 55 microIU/mL (ROC curve AUC: 72%), isolation was successful in 12/19 donors with high AIRarg and in 1/10 donors with low AIRarg (p < 0.001). The negative and positive predictive values were 90 and 63%, respectively. If used to select donors in the entire cohort, AIRarg would have increased our success rate by 40% and avoided 56% of unsuccessful isolations while missing only 8% of successful preparations. Our results suggest that donor AIRarg is markedly superior to body mass index (BMI) and other criteria currently used to predict isolation outcome. If routinely performed in deceased donors, this simple test could significantly reduce the failure rate of human islet isolation.
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Affiliation(s)
- T Hubert
- INSERM U859, Thérapie Cellulaire du Diabète, Faculté de Médecine, Lille, France
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Caiazzo R, Gmyr V, Hubert T, Delalleau N, Lamberts R, Moerman E, Kerr-Conte J, Pattou F. Evaluation of alternative sites for islet transplantation in the minipig: interest and limits of the gastric submucosa. Transplant Proc 2007; 39:2620-3. [PMID: 17954193 DOI: 10.1016/j.transproceed.2007.08.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Since the introduction of glucocorticoid-free immunosuppressive regimens, islet transplantation offers a less invasive alternative to pancreas transplantation. However, complications associated with intraportal islet injection and the progressive functional decline of intrahepatic islets encourage the exploration of alternative sites. Herein we evaluated, in the minipig, the use of the gastric submucosa (GS; group 1, n = 5) for islet transplantation compared with the kidney capsule (KC; group 2, n = 5). Subsequently we attempted to improve the vascularization of the submucosal graft (group 3, n = 5) by the addition of an extracellular matrix rich in growth factors (Matrigel). One month after grafting, we evaluated transplanted islet function in vivo and in vitro. Our study showed better function of islets engrafted in the GS than in the KC (P < .05). Despite the growth factors, Matrigel did not offer a more suitable environment to further improve engraftment (group 3, P < .05). Thus, even if the liver remains the gold standard, the GS represents a potential islet engraftment site, confirming the data obtained in vitro and in the rodent. Offering easy access by endoscopy, this site could constitute an interesting alternative for experimental studies in large mammals and, eventually, for clinical application.
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Affiliation(s)
- R Caiazzo
- INSERM UNIT-M 859, Diabetes Cell Therapy, Faculty of Medicine, Lille 2 University, 1 Place de Verdun, 59045 Lille, France.
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Dufrane D, Nenquin M, Henquin JC. Nutrient control of insulin secretion in perifused adult pig islets. DIABETES & METABOLISM 2007; 33:430-8. [PMID: 17584514 DOI: 10.1016/j.diabet.2007.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Revised: 04/24/2007] [Accepted: 05/03/2007] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Xenotransplantation of pig islets is a potential solution to the shortage of human islets, but our knowledge of how these islets secrete insulin in response to nutrients is still fragmentary. This was the question addressed in the present study. METHODS After 24 h culture adult pig islets were perifused to characterize the dynamics of insulin secretion. Some responses were compared to those in human islets. RESULTS Increasing glucose from 1 to 15 mM weakly (approximately 2x) stimulated insulin secretion, which was potentiated (approximately 12x) by the cAMP-producing agent, forskolin. The effect of glucose was concentration-dependent (threshold at 3-5 mM and maximum at approximately 10 mM). The pattern of secretion was biphasic with a small first phase and an ascending second phase, and a paradoxical increase when the glucose concentration was abruptly lowered. Diazoxide abolished glucose-induced insulin secretion and tolbutamide reversed the inhibition. Glucose also increased secretion when islets were depolarized with tolbutamide or KCl. Insulin secretion was increased by leucine+glutamine, arginine, alanine or a mixture of amino acids, but their effect was significant only in the presence of forskolin. Upon stimulation by glucose alone, human islets secreted approximately 10x more insulin than pig islets, and the kinetics was characterized by a large first phase, a flat second phase, and rapid reversibility. CONCLUSIONS Compared with human islets, in vitro insulin secretion by adult pig islets is characterized by a different kinetics and a major quantitative deficiency that can be corrected by cAMP.
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Affiliation(s)
- D Dufrane
- Unit of Endocrinology and Metabolism, University of Louvain Faculty of Medicine, UCL 55.30, avenue Hippocrate 55, 1200 Brussels, Belgium
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Kim JH, Kim HI, Lee KW, Yu JE, Kim SH, Park HS, Park CG, Ihm SH, Ha J, Kim SJ, Lee HK, Ahn C, Park KS. Influence of strain and age differences on the yields of porcine islet isolation: extremely high islet yields from SPF CMS miniature pigs. Xenotransplantation 2007; 14:60-6. [PMID: 17214705 DOI: 10.1111/j.1399-3089.2006.00364.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Porcine pancreas is a potential source of material for islet xenotransplantation. However, the difficulty in isolating islets, because of their fragility and the variability of isolation outcome in donor age and breed, represents a major obstacle to porcine islet xenotransplantation. In this study, we compared the islet isolation yield of specific pathogen-free (SPF) Chicago Medical School (CMS) miniature pigs with that of another miniature pig breed and market pigs from a local slaughterhouse. METHODS Nine adult CMS miniature (ACM) pigs (>12 months), six young CMS miniature (YCM) pigs (6-7 months), four adult Prestige World Genetics (PWG) miniature (APM) pigs (>12 months), and 13 adult market (AM) pigs from a local slaughterhouse were used for islet isolation. RESULTS The islet yield per gram of pancreas from ACM pigs (9589 +/- 2823 IEQ/g) was significantly higher than that from APM pigs (1752 +/- 874 IEQ/g, P < 0.05), AM pigs (1931 +/- 947 IEQ/g, P < 0.05), or YCM pigs (3460 +/- 1985 IEQ/g, P < 0.05). Isolated islets from ACM pigs were significantly larger than those from AM pigs or YCM pigs. The in vitro and in vivo function of isolated islets showed no difference among experimental groups. The pancreases of ACM pigs contained higher mean islet volume density percentages and larger size of islets than those of AM or APM pigs. CONCLUSIONS We isolated extremely high yields of well-functioning islets from ACM pigs bred under SPF conditions. SPF CMS miniature pigs should be one of the best porcine islet donors for clinical porcine islet xenotransplantation.
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Affiliation(s)
- Jae Hyeon Kim
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, Korea
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Bottino R, Balamurugan AN, Smetanka C, Bertera S, He J, Rood PPM, Cooper DKC, Trucco M. Isolation outcome and functional characteristics of young and adult pig pancreatic islets for transplantation studies. Xenotransplantation 2007; 14:74-82. [PMID: 17214707 DOI: 10.1111/j.1399-3089.2006.00374.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Pig islets have been proposed as an alternative to human islets for clinical use, but their use is limited by rejection. The availability of genetically modified pigs devoid of alpha1,3-galactosyltransferase might provide islets more suitable for xenotransplantation. To limit the costs involved in the logistics and health care of pigs for clinical xenotransplantation, we have studied whether younger, rather than older, pigs that are typically preferred can be used as islet donors. METHODS We utilized pancreases from Yorkshire and White Landrace wild-type pigs and alpha1,3-galactosyltransferase gene-knockout pigs of three main different age and size groups: (i) <6 months, (ii) 6 to 12 months, and (iii) >2 yr of age, inclusive of retired breeders. We compared isolation yield and in vitro and in vivo function of islet cells obtained from these groups. RESULTS Islets from adult pigs (>2 yr) offered not only higher islet yields, but retained the ability to preserve intact morphology during the isolation process and culture, in association with high functional properties after transplantation. Following isolation, islet cells from young (<6 m) and young-adult (6 to 12 m) pigs dissociated into small aggregates and single cells, and exhibited inferior functional properties than adult islets both in vitro and in vivo. CONCLUSIONS These data support the conclusion that, in view of the large number of islets needed to maintain normoglycemia after xenotransplantation, organ-source pigs need to reach adult age (>2 yr) before being considered optimal islet donors, in spite of the higher costs involved.
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Affiliation(s)
- Rita Bottino
- Division of Immunogenetics, Department of Pediatrics, Children's Hospital of Pittsburgh, Rangos Research Center, Pittsburgh, PA 15213, USA.
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Hubert T, Gmyr V, Arnalsteen L, Jany T, Triponez F, Caiazzo R, Vandewalle B, Vantyghem MC, Kerr-Conte J, Pattou F. Influence of Preservation Solution on Human Islet Isolation Outcome. Transplantation 2007; 83:270-6. [PMID: 17297400 DOI: 10.1097/01.tp.0000251723.97483.16] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The influence of the preservation solution used for in situ perfusion of the donor and pancreas storage on islet isolation has received little attention. METHODS In this prospective controlled trial, we compared the outcome of human islet isolation from pancreata perfused with University of Wisconsin (UW) solution or Celsior, an alternative colloid-free extracellular solution. RESULTS At the 1-year interim analysis, the viability and insulin secretion of islets isolated from donors perfused with UW (n=19) or Celsior (n=5) were identical. However, total islet recovery (IEQ) and isolation yield (IEQ/g) were 1.8-fold and 2.1-fold inferior in the Celsior group (P<0.05 vs. UW). Overall, 13 (68%) of islet preparations were effectively transplanted from the UW group vs. none from the Celsior group (P=0.01). The clinical study was discontinued and the causes of these differences were further explored in the pig (n=14). In contrast to UW, Celsior induced cell swelling and pancreas edema after only four hours of cold storage. These abnormalities were delayed when the donor was perfused with Solution de Conservation d'Organes et de Tissus (SCOT), an extracellular solution containing polyethylene glycol. CONCLUSIONS Our results suggest that colloid-free preservation solutions might be suboptimal for pancreas perfusion and cold storage prior to islet isolation and transplantation. Because pancreata are now frequently recovered for islet transplantation, preliminary experimental and clinical data about islet isolation should be obtained prior to the routine implementation of new preservation solutions for abdominal perfusion during multiorgan recovery.
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Affiliation(s)
- Thomas Hubert
- Inserm U859, Diabetes Cell Therapy, Faculty of Medicine, Lille 2 University, Lille, France
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Marcelli-Tourvieille S, Hubert T, Pattou F, Vantyghem MC. Acute insulin response (AIR): review of protocols and clinical interest in islet transplantation. DIABETES & METABOLISM 2006; 32:295-303. [PMID: 16977256 DOI: 10.1016/s1262-3636(07)70283-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Various stimuli have been used in clinical practice to test islet function, including intravenous glucose, arginine--both at basal glucose levels and with the hyperglycaemic clamp, tolbutamide, glucagon and glucagon-like peptide 1. The subsequent first phase insulin response (also termed acute insulin response or AIR) to intravenous glucose or arginine has been quantified in a variety of ways, from the mean serum insulin measured at multiple times after glucose injection to the mean value above baseline of serum insulin at 2 to 10 min. The purpose of this study was to review the different protocols of AIR calculation and their pitfalls, and to assess the results of AIR in the islet transplantation field. By investigating the first phase of insulin secretion, AIR provides both a qualitative and a quantitative approach to insulin secretion. In islet transplantation, post-glucose AIR (AIRg) may predict graft survival while post-arginine AIR (AIRa) may be better correlated with engrafted beta cell mass, despite these facts need to be confirmed. AIRa also limits intravenous hyperglycaemia glucotoxicity. In conclusion, AIR could help to predict the need for a second or third islet injection in islet transplantation. These specific indications, however, need to be confirmed by future studies and completed by other approaches such as insulin sensitivity studies and in vivo morphological assessment of islet mass.
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Hubert T, Arnalsteen L, Jany T, Prieur E, Triponez F, Nunes B, Vantyghem MC, Gmyr V, Kerr-Conte J, Proye C, Pattou F. Technique du prélèvement pancréatique pour l'isolement des îlots de Langerhans. ACTA ACUST UNITED AC 2005; 130:384-90. [PMID: 16023459 DOI: 10.1016/j.anchir.2005.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Accepted: 02/04/2005] [Indexed: 01/23/2023]
Abstract
AIM OF THE STUDY The allograft of pancreatic islets represents a potential alternative to insulin therapy in patients suffering from the most severe forms of Type 1 diabetes. Here we report our experience of pancreatic procurement for isolation and islet allograft. MATERIALS AND METHODS Pancreata were procured in brain-dead donors. The islets were isolated using techniques developed and validated in pigs and men. Injection of a given preparation was decided after quantitative and qualitative controls. Islets were transplanted in Type 1 diabetic patients already grafted with a kidney or suffering from severe and/or unstable diabetes, after percutaneous or surgical settlement of an intra-portal catheter. Patients received an "Edmonton-like" immunosuppressive protocol. Grafts were repeated once or twice until a total quantity of 10,000 transplanted islet-equivalents was obtained. RESULTS Twenty-nine pancreata were procured and 14 preparations were grafted to 7 patients. Eleven graftings were done percutaneously and three were surgical. The initial function of the 14 transplants was confirmed by secretion of C-peptide and decrease of insulin doses. Insulin therapy was completely interrupted in the 5 patients having received at least two grafts. CONCLUSION These preliminary clinical results confirmed that the isolation technique of human islets and the technique of pancreas procurement are mastered by our team. If the results of this assay (assessment one year after graft) confirm our hopes, we will be able to offer islet allografts to an increasing number of patients with severe Type 1 diabetes.
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Affiliation(s)
- T Hubert
- Equipe INSERM ERIT-M 0106 thérapie cellulaire du diabète, faculté de médecine, pôle recherche, centre hospitalier régional et universitaire de Lille, 59045 Lille cedex, France
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