Key words: insulin dependent deabetes mellitus, pancreatic islets, transplantation, cryopreservation, immunomodulat ion

Transcription

1 Key words: insulin dependent deabetes mellitus, pancreatic islets, transplantation, cryopreservation, immunomodulat ion

2 Fig. 1 Number of adult islet all grafts by year performed from 1974 through 1993

3 Fig. 3 Fasting blood glucose levels in transplant rats and diabetic rats. The shaded area indicates the confidence band for fasting blood glucose in normal rats. Irig. 5 Histological studies of cytopreserved islet (H-E staining Orig. x560) Streptozoiocin Weeks After Transolanl

4 Table 1 Effects of cryopreservation on glucose stimulated insulin release from hamster pancreatic islets. Values of insulin release and expressed as /U/10islets/60min Islet frozen at l"c/min Islet frozen at 25'C/min non-frozen cultured islet Glucose concentration F rsa.r+sa.z +ro.s+ror.: ]'-] rer s*.rz.s I azs.star.s -,-] Table 2 islets Effects of cryopreservation on insulin and DNA content of hamster pancreatic Islet frozen at 1'C/min Islet frozen at 25'C/min non-frozen cultured islet Fig. 6 Blood glucose level of streptozotocin diabetic hamsters implanted into the renal subcapsular space with about 1,000hamster islets. Nephrectomy was performed on the 56th day after transplantation. lslet Transplant

5 llig. 8 Glucose stimulated insulin release from FCIC and CI. Values of insulin rerease are expres' sed as pul10islets/60min

6 Fig. 9 Effect of isogeneic FCIC transplantation on blood glucose levels. Blood glucose levels of three streptozotocin diabetic rats to Transplantation of FCIC isografts. Nephrectomy rvas performed on the Sth day after transplantation. after transplant Fig. 10 SDS-PAGE of proteins derived ftom each group of islet cells FCIC (lane a) : Pseudoislets u.ich were formed from dissoclated islet cells in vitro culture after f reezi ng-thawing process. PI (lane b) : Pseudoislets wich u'ere formed from dissociated islet cells in vitro culture. CI (lane c) : Non-frozen cultured islet. IC (lane d) : islet cells directly after dissociation. Moleculer weight standards are listed on the right. Days

7 7 (667) Table 3 Effects of cryopreservation on glucose stimulated insulin release from new born hamster pancreatic islets. Values of insulin release are expressed as lul10islets/60min Glucose concentration 3days cultured lweek cultured 2weeks cultured

8 -186, ) Ballinger WF, Lacy PE: Transplantation of intact pancreatic islets in rats. Surgery 72: I75 8) Najarian JS, Sutherland DER, Goetz FC et al : Human islets transplantation. A preliminary report. Transplant Proc 9: , ) Federlin K, Bretzel RG, Hering BJ : International islet transplant registry. News Letter , ) Horaguchi A, Merrell RC: Preparation of viable islets cells from dogs by a new method. Diabetes 30 : l) Gray DWR, McShane P, Grant A et al: A method for isolation of islets of Langerhans from the human pancreas. Diabetes 33 : 105b ) Ohzato H, Gotoh M, Monden M: Intraductal injection of collagenase solution at the time harvesting-a possible solution for preservation and collagenase digestion. Transplant Proc 22 (Suppl. 2): , ) Ricordi C, Lacy PE, Finke EH et al : Automated method for isolation of human pancreatic islets. Diabetes 37 : ) Kojima Y, Nakagawara G, Miyazaki I: Culture of the islets of Langerhans for transplantation. Jpn J Surg 12: 71 75, ) Kemp CB, Knight MJ, Lacy PE: Effect of transplantation site on the results of pancreatic islet isograft in diabetic rats. Diabetologia 9 i ) Ballinger WF, Lacy PE: Transplantation of intact pancreatic islets in rats. Surgery 72: I ) Nakagawara G, Kojima Y, Miyazaki I: Insulin-releasing activity and successful transplantation of pancreatic islets preserved by tissue culture. Surgery 83 : , ) Warnock GL, Degroot T, Rajotte RV: The natural history of pure canine islet autografts in hepatic or splenic sites. Transplant Proc 21 l , ) Hara Y, Taniguchi H, Ishihara K: Successful interthecal transplantation of islet without immunosuppressive drugs. Recent advances in insulin therapy. Amsterdam, Elsevier Science Publishers B.V, 1990, p ) Gores PE, Najarian JS, Sutherland DE et al: Insulin independence in type I diabetes after transplantation of unpurified islets from single donor with 15-deoxy-spergulin. Lancet 341 : 19-2r, 7993

9 Ono J, Takaki R, Fukuma M: Preperation of single cells from pancreatic islets of adult rat by the use of Dispase. Endocrinol Jpn 24 : , t977 Krmura T, Nakagawara G: Prolonging survival of islet allograft by pretreating isolated islets with X-ray irradiation. Transplant Proc 26: Transplantation of Pancreatic Islets Gizo Nakagawara First Department of Surgery, Fukui Medical School Islet transplantation in Type I insulin-dependent diabetus mellitus (IDDM) has some advantages over vascularized pancreas organ transplantation, such as the easy and safe technique of transplantation, and the possibility of immunomodulation of the graft. But data from clinical studies have shown that some scrious problems still need to be overcome. One of the problems islet transplatation is the islet storage. There are some preservation methods, including culture, low temperature preservation, and cryopreserva' tion, but cryopreservation may be the only possible method of long-term preservation. Islets can be cryopreserved without loss of their biological activity by using the cooling rate of l"c/min and 25"C/min. And cryopreserved isolets can normalize the blood glucose level of diabetic hamsters in isogenic trnasplantation. To reduce the immunogenicity of the islets, isolated pancreatic islets were dissociated into islet celis and cryopreserved. There was a significant prolongation of survival of dissociated and cryopreserved islet cells in ailogenic transplantation in rats. Irradiation of islets and encapsulation of islets were also examined and these methods were useful for controlling rejection in islet transplantation. We believe these approaches wiil permit application of these methods to the treatment of diabetes in human with allorgrafts xenografts. Reprint requests: Gizo Nakagawara First Department of Surgery, Fukui Medical School 23 Shimoaizuki, Matsuokacho, Yoshidagun, Fukui, JAPAN