Evidence for Instant Blood-Mediated Inflammatory Reaction in Clinical Autologous Islet Transplantation
Evidence for Instant Blood-Mediated Inflammatory Reaction in Clinical Autologous Islet Transplantation
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DOI：
10.1111/ajt.12558
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发表时间：
2014-02-01
影响因子：
8.8
通讯作者：
Levy, M. F.
中科院分区：
文献类型：
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作者：
Naziruddin, B.;Iwahashi, S.;Levy, M. F.
当同种异体或异种胰岛与血液接触时，已报道了称为即时血液介导的炎症反应（IBMIR）的非特异性炎症和血栓形成反应。已知该反应会导致移植胰岛的显著损失。我们假设IBMIR发生在接受全胰腺切除术后自体胰岛移植（TP-AIT）的患者中，并在24例患者和体外模型中验证了这一假设。在移植围术期采集的血样显示，在胰岛输注期间，凝血酶-抗凝血酶III复合物（达特）和C肽显著快速增加，持续长达3小时，沿着血小板计数降低。观察到炎性蛋白IL-6、IL-8和干扰素诱导蛋白-10水平的伴随增加。由纯胰岛加自体血组成的体外模型也显示达特水平显著增加（p
A nonspecific inflammatory and thrombotic reaction termed instant blood-mediated inflammatory reaction (IBMIR) has been reported when allogenic or xenogenic islets come into contact with blood. This reaction is known to cause significant loss of transplanted islets. We hypothesized that IBMIR occurs in patients undergoing total pancreatectomy followed by autologous islet transplantation (TP-AIT) and tested this hypothesis in 24 patients and in an in vitro model. Blood samples drawn during the peritransplant period showed a significant and rapid increase of thrombin-anti-thrombin III complex (TAT) and C-peptide during islet infusion, which persisted for up to 3h, along with a decreased platelet count. A concomitant increase in levels of inflammatory proteins IL-6, IL-8 and interferon-inducible protein-10 was observed. An in vitro model composed of pure islets plus autologous blood also demonstrated significantly increased levels of TAT (p