Detection of the marker for acute rejection in pancreas islet transplantation

胰岛移植与全胰腺移植相比有几个优点。这种疗法的临床建立是可取的。然而，仍有许多障碍限制了该疗法的广泛应用。难以从一个胰腺中分离出足够质量的胰岛就是其中一个障碍。为了解决这一问题，我们在胰岛分离前采用双层冷藏法保存胰腺。一个胰腺的胰岛产量是常规保存方法的两到三倍。在这项研究中，我们关注的是胰岛移植急性排斥反应的标志物。到目前为止，还没有有效的方法来检测胰岛移植的排斥反应。为了更好的免疫抑制方案，建立移植物监测系统是必不可少的。以前，我们报道了血清胰分泌胰蛋白酶抑制剂（PSTI）是胰腺移植急性排斥反应的有用标志物。这一次，我们试图确定PSTI在胰岛移植中是否也有用。不幸的是，由于技术原因，无法测量血清PSTI。然后我们将重点放在移植胰岛所在的肝脏上。我们试图研究狗自体和/或同种异体胰岛移植模型中每日血糖水平与肝酶（如GOT、GPT、_gtp）之间的关系。在一些同种异体移植模型中观察到血清GPT在血清血糖水平升高之前升高。在自体移植中，没有观察到这种变化。我们的结论是血清GPT可用于检测胰岛移植急性排斥反应，尽管特异性不高。组织学检查，常规HE染色未见明显改变。为了进一步了解胰岛移植急性排斥反应的机制，必须进行包括特殊染色组织学检查在内的额外研究。

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.