Detection of the marker for acute rejection in pancreas islet transplantation

点击翻译按钮获取中文摘要

Pancreas islet transplantation has several advantages over whole pancreas transplantation. The clinical establishment of this therapy is desirable. However, there still remains many obstacles which limit widespread application of this therapy.Difficulty in isolating enough islets with sufficient quality from one pancreas is one of such obstacles. For resolve this problem, we applied the two-layer cold storage method to pancreas preservation before islet isolation.The yield of islets from one pancreas becomes two to three fold compared to that with usual preservation method.In this study, we focused on the marker for acute rejection in islet transplantation. So far no useful means to detect graft rejection in islet transplantation are available. For better immunosuppressive protocol, establishment of graft monitoring system is essential. Previously, we reported that serum PSTI (Pancreatic Secretory Trypsin Inhibitor) is an useful marker for acute rejection in pancreas transplantation. This time we sought to determine whether PSTI is also useful in islet transplantation. Unfortunately, for technical reason, measurement of serum PSTI was impossible. Then we focused on the liver where transplanted islets reside. We tried to investigate the relationship between daily blood sugar levels and liver enzymes, such as GOT, GPT, _-GTP in dog auto and/or allo islet transplantation models. Elevation of serum GPT preceding elevation of serum blood sugar level was observed in some allo transplant models. In auto transplant, no such changes were observed. We concluded that serum GPT may be used to detect acute rejection in islet transplant, although the specificity is not high.Histological examination showed no apparent changes in usual HE staining. For further understanding the mechanism of acute rejection in islet transplantation, additional study including histological examination using special staining is mandatory.