Stimulating beta cell replication and improving islet graft function by GPR119 agonists

G protein-coupled receptor 119 (GPR119) is predominantly expressed in β cells and intestinal L cells. In this study, we investigated whether oleoylethanolamide (OEA), a GPR119 endogenous ligand, and PSN632408, a GPR119 synthetic agonist, can stimulate β-cell replication in vitro and in vivo and improve islet graft function in diabetic mice. We found that OEA and PSN632408 significantly increased numbers of insulin(+)/5-bromo-2'-deoxyuridine (BrdU)(+) β cells in cultured mouse islets in a dose-dependent manner. All diabetic recipient mice, given marginal syngeneic islet transplants with OEA or PSN632408 or vehicle, achieved normoglycemia at 4 weeks after transplantation. However, normoglycemia was achieved significantly faster in OEA- or PSN632408-treated diabetic mice than in vehicle-treated diabetic mice (P < 0.05). The percentage of insulin(+)/BrdU(+) β cells in islet grafts in OEA- and PSN632408-treated mice was significantly higher than in vehicle-treated mice (P < 0.01). Our data demonstrated that OEA and PSN632408 can stimulate β-cell replication in vitro and in vivo and improve islet graft function. Targeting GPR119 is a novel therapeutic approach to increase β-cell mass and to improve islet graft function by stimulating β-cell replication.     

Effect of glucagon-like peptide-1 gene expression on graft function in mouse islet transplantation

This study investigated the effect of local glucagon‐like peptide‐1 (GLP‐1) production within mouse islets on cytoprotection in vitro and in vivo by gene transfer of GLP‐1. Transduction of recombinant adenovirus vector expressing GLP‐1 (rAd‐GLP‐1) induced a significant increase in bioactive GLP‐1 in the mouse islet culture, whereas transduction with adenovirus vector expressing β‐galactosidase (rAd‐LacZ), as a control, had no effect on GLP‐1 secretion. Islets transduced with rAd‐GLP‐1 were protected from H₂O₂‐induced cell damage in vitro. In addition, glucose‐stimulated insulin secretion was significantly increased in rAd‐GLP‐1‐transduced islets. When transplanted under the kidney capsule of diabetic syngeneic mice, islet grafts retrieved 4 or 7 days after transplantation revealed that the rAd‐GLP‐1‐transduced group had significantly more Ki67‐positive cells as compared with the rAd‐LacZ‐transduced group. Regarding blood glucose control, diabetic mice transplanted with a marginal mass of rAd‐GLP‐1‐transduced islets became normoglycemic more rapidly and 78% of the recipients were normoglycemic at 35 days post‐transplant, whereas only 48% of the mice transplanted with rAd‐LacZ‐transduced islets were normoglycemic (P < 0.05). In conclusion, delivery of the GLP‐1 gene to islets enhanced islet cell survival during the early post‐transplant period, and preserved islet mass and functions over time in the transplants.     

Natural human antibody-mediated destruction of porcine neonatal islet cell grafts

Abstract: Porcine pancreata may be considered a potential source of islets for transplantation into diabetic recipients; however, whether porcine islet grafts will be susceptible to damage by natural antibody-mediated hyperacute rejection remains unknown. In this study, we performed Western blots to determine whether membrane proteins present on porcine neonatal islet cells (NIC) are recognized by xenoreactive antibodies present in human sera. Western blots of freshly isolated porcine NICs with AB sera detected the presence of 14 antigens (MW 24–164 kDa) and 4 antigens (MW 101–150 kDa) to which antiserum against human IgM and IgG bound, respectively. The most prominent antigens with IgM reactivity had MWs of 36, 63, and 120 kDa, whereas for IgG, the most intensely reactive antigen had a MW of 120 kDa. When membrane fractions prepared from purified porcine aortic endothelial cells and LLC-PK1 cells were analyzed, the major antigens had molecular weights comparable to those seen for NICs. After culturing the NICs for 5 days, the number of detected xenoreactive antigens binding IgM or IgG decreased and the antigens present at 36, 63, and 120 kDa with IgM reactivity were shown to have a decreased intensity of binding. Incubation of cultured porcine NICs for 18 hr in the presence of human AB serum containing complement resulted in a 55% loss of cellular insulin content (P < 0.0001), a 45% reduction in recoverable DNA (P < 0.0001), and a marked reduction in insulin secretory response to an in vitro glucose challenge. Recovery and viability of porcine NICs was not affected when incubated with AB serum depleted of anti-Gal antibodies with Synsorb 90. These results demonstrate that natural human antibodies of both IgM and IgG subtypes bind to antigens present on Department of Laboratory Medicine and complement reduces islet cell survival and functional viability. Adsorbing serum with the αGal(1–3)βGal(1–4)βGlc carbohydrate removes natural human antibody-mediated destruction of porcine neonatal islet cell grafts.     

The capsular overgrowth on microencapsulated pancreatic islet grafts in streptozotocin and autoimmune diabetic rats

This study investigates whether capsular overgrowth on alginate-polylysine microencapsulated islets is influenced by (1) the presence of islet tissue, (2) MHC incompatibility between donor and recipient, or (3) the presence of autoimmune diabetes. Encapsulated Albino Oxford (AO, n=6, isografts) and Lewis (n=6, allografts) rat islets, and encapsulated human islets (n=5, xenografts) were implanted intraperitoneally into streptozotocin-diabetic AO rats. Also, encapsulated AO islets were implanted into autoimmune diabetic Bio Breeding/Organon (BB/O) rats (n=5, allografts). Five isografts, five allografts, and three xenografts in AO recipients and five allografts in BB/O recipients resulted in normoglycemia. Two weeks after implantation, islets containing capsules were retrieved by peritoneal lavage, after which all animals that had become normoglycemic after transplantation returned to a state of hyperglycemia. Recovery rates of the capsules of these successful grafts, expressed as percentages of the initially implanted graft volume, varied from 72%±7% to 80%±9%. The associated pericapsular infiltrates (PCI) were similar in all groups and varied from 3.2%±1.4% to 8.3%±2.6%. Similar recovery rates and PCI were also found with empty capsules. However, the recovery rates of recipients with graft failures were lower and showed more PCI. Immunohistological staining of PCI showed no differences in the types of cells in the PCI on capsules with or without islets. We conclude that this early PCI is a capsule-induced foreign body reaction that is not influenced by MHC incompatibility or by the presence of autoimmune diabetes, and it should be avoided by improving the biocompatibility of the capsules.     

Xenoreactive CD4+ memory T cells resist inhibition by anti-CD44 mAb and reject islet grafts via a Th2-dependent pathway

Peng YZ, Chen JB, Shao W, Wang FY, Dai HL, Cheng PP, Xia JJ, Wang F, Huang R, Zhu Q, Qi Z. Xenoreactive CD4⁺ memory T cells resist inhibition by anti‐CD44 mAb and reject islet grafts via a Th2‐dependent pathway. Xenotransplantation 2011; 18: 252–261. © 2011 John Wiley & Sons A/S. Abstract: Background: Memory T cells are a significant barrier to the induction of transplant tolerance. Our previous study demonstrated that multiple applications of anti‐CD44 monoclonal antibody (mAb) could significantly inhibit CD4⁺ memory T cells from mediating rejection of cardiac allografts. Now, we sought to explore the effect and mechanism of anti‐CD44 mAb on the rejection of islet allografts and xenografts mediated by CD4⁺ memory T cells. Methods: In this study, we first engrafted skin grafts of C57BL/6 (B6) mice or Dark Agouti (DA) rats onto BALB/c mice to induce donor‐reactive memory T cells. We adoptively transferred purified CD4⁺ memory T cells to BALB/c origin nude mice and then transplanted islet allografts and xenografts to produce the Allo‐Tx and Xeno‐Tx models, respectively. We subsequently administered multiple anti‐CD44 mAb and observed changes in the survival times of the islet grafts. Results: In the Allo‐Tx model, the mean survival time (MST) of the grafts was 7.7 days in the isotype group, and 20.3 days in the anti‐CD44 group. In the Xeno‐Tx model, the MST of the grafts was 7.2 days in the isotype group and 8.2 days in the anti‐CD44 group. Compared with the isotype group, CD4⁺ T cells on the grafts in the anti‐CD44 group were significantly decreased in both the Allo‐Tx and Xeno‐Tx models, but the proportion of CD4⁺ memory T cells in the spleens and draining lymph nodes of the recipient nude mice in the anti‐CD44 group was significantly decreased in the Allo‐Tx model, while it was increased in the Xeno‐Tx model. The production of donor‐specific IgG antibody in the anti‐CD44 group did not vary in the Allo‐Tx model, while it was markedly elevated in the Xeno‐Tx model. Furthermore, the expression of interferon gamma in the anti‐CD44 group was markedly decreased in both the Allo‐Tx and Xeno‐Tx models, while the expression of IL‐4 in the anti‐CD44 group was significantly increased only in the Xeno‐Tx model. Conclusion: Multiple applications of the anti‐CD44 mAb could significantly inhibit donor‐reactive CD4⁺ memory T cells from rejecting grafts via a Th1‐dependent pathway, but xenoreactive CD4⁺ memory T cells can avoid the effects of anti‐CD44 mAb to reject islet xenografts via a Th2‐dependent pathway.     

Exendin‐4, a Glucagon‐Like Peptide‐1 Receptor Agonist,Prevents Osteopenia by Promoting Bone Formation and Suppressing Bone Resorption in Aged Ovariectomized Rats

Osteoporosis mainly affects postmenopausal women and older men. Gastrointestinal hormones released after meal ingestion, such as glucose‐dependent insulinotropic peptide (GIP) and glucagon‐like peptide (GLP)‐2, have been shown to regulate bone turnover. However, whether GLP‐1, another important gastrointestinal hormone, and its analogues also have antiosteoporotic effects, especially in aged postmenopausal situation, has not been confirmed. In the present study, we evaluated the effects of the GLP‐1 receptor agonist exendin‐4 on ovariectomy (OVX)‐induced osteoporosis in old rats. Twelve‐month‐old female Sprague‐Dawley rats were subjected to OVX, and exendin‐4 was administrated 4 weeks after the surgery and lasted for 16 weeks. Bone characters and related serum and gene biomarkers were analyzed. Sixteen weeks of treatment with exendin‐4 slowed down body weight gain by decreasing fat mass and prevented the loss of bone mass in old OVX rats. Exendin‐4 also enhanced bone strength and prevented the deterioration of trabecular microarchitecture. Moreover, exendin‐4 decreased the urinary deoxypyridinoline (DPD)/creatinine ratio and serum C‐terminal cross‐linked telopeptides of type I collagen (CTX‐I) and increased serum alkaline phosphatase (ALP), osteocalcin (OC), and N‐terminal propeptide of type 1 procollagen (P1NP) levels, key biochemical markers of bone turnover. Interestingly, gene expression results further showed that exendin‐4 not only inhibited bone resorption by increasing the osteoprotegerin (OPG)/receptor activator of NF‐κB ligand (RANKL) ratio, but also promoted bone formation by increasing the expression of OC, Col1, Runx2, and ALP, which exhibited dual regulatory effects on bone turnover as compared with previous antiosteoporotic agents. In conclusion, these findings demonstrated for the first time the antiosteoporotic effects of exendin‐4 in old OVX rats and that it might be a potential candidate for treatment of aged postmenopausal osteoporosis.     

Three‐dimensional ex vivo imaging and analysis of intraportal islet transplants

In clinical islet transplantation, because the long‐term insulin‐independence rate is still poor, a method for detailed analysis of the transplanted islets in the liver after transplantation is required. We have established a novel imaging technique suitable for analysis of transplanted islets in liver using an optical projection tomography (OPT) method. A three‐dimensional tomographic image of the transplanted islets in liver was reconstructed. The number of islets transplanted and the number of transplanted islets observed using OPT showed good correlation. The OPT method was used to compare the numbers of transplanted islets in mouse syngeneic and allogeneic transplantation models. Blood glucose concentrations of streptozotocin (STZ)‐induced diabetic mice transplanted with syngeneic islets remained normoglycemic and the number of transplanted islets was largely preserved 11 days after transplantation. In mice transplanted with allogeneic islets, hyperglycemia recurred from 7 days after transplantation and the number and the volume of transplanted islets was significantly reduced 11 days after transplantation. These results indicate that OPT imaging and analysis may be a useful tool to quantitatively and sterically evaluation of transplanted islets in liver at the cellular level.     

Suppressing memory T cell activation induces islet allograft tolerance in alloantigen‐primed mice

Memory T cells are known to play a key role in prevention of allograft tolerance in alloantigen‐primed mice. Here, we used an adoptively transferred memory T cell model and an alloantigen‐primed model to evaluate the abilities of different combinations of monoclonal antibodies (mAb) to block key signaling pathways involved in activation of effector and memory T cells. In the adoptively transferred model, the use of anti‐CD134L mAb effectively prevented activation of CD4⁺ memory T cells and significantly prolonged islet survival, similar to the action of anti‐CD122 mAb to CD8⁺ memory T cells. In the alloantigen‐primed model, use of anti‐CD134L and anti‐CD122 mAbs in addition to co‐stimulatory blockade with anti‐CD154 and anti‐LFA‐1 prolonged secondary allograft survival and significantly reduced the proportion of memory T cells; meanwhile, this combination therapy increased the proportion of regulatory T cells (Tregs) in the spleen, inhibited lymphocyte infiltration in the graft, and suppressed alloresponse of recipient splenic T cells. However, we also detected high levels of alloantibodies in the serum which caused high levels of damage to the allogeneic spleen cells. Our results suggest that combination of four mAbs can significantly suppress the function of memory T cells and prolong allograft survival in alloantigen primed animals.     

Effect of hypoxia‐inducible VEGF gene expression on revascularization and graft function in mouse islet transplantation

For gene transfer strategies to improve islet engraftment, vascular endothelial growth factor (VEGF) expression should be regulated in a way that matches the transient nature of revascularization with simultaneously avoiding undesirable effects of overexpression. The aim of this study was to investigate the effects of hypoxia‐inducible VEGF gene transfer using the RTP801 promoter on islet grafts. We implanted pSV‐hVEGF transfected, pRTP801‐hVEGF transfected or nontransfected mouse islets under the kidney capsule of streptozotocin‐induced diabetic syngeneic mice. Human VEGF immunostaining of day 3 grafts revealed that the pRTP801‐hVEGF transfected group had higher hVEGF expression compared with the pSV‐hVEGF transfected group. BS‐1 staining of day 3 grafts from the pRTP801‐hVEGF transfected group showed the highest vascular density, which was comparable with day 6 grafts from the nontransfected group. In 360 islet equivalent (IEQ)‐transplantation which reverted hyperglycemia in all mice, the area under the curve of glucose levels during intraperitoneal glucose tolerance test 7 weeks post‐transplant was lower in mice transplanted with pRTP801‐hVEGF transfected grafts compared with mice transplanted with nontransfected grafts. In 220 IEQ‐transplantations, diabetic mice transplanted with pRTP801‐hVEGF islets became normoglycemic more rapidly compared with mice transplanted with pSV‐hVEGF or nontransfected islets, and diabetes reversal rate after 50 days was 90%, 68%, and 50%, respectively. In conclusion, our results indicate that regulated overexpression of hVEGF in a hypoxia‐inducible manner enhances islet vascular engraftment and preserves islet function overtime in transplants.     

Cyclophosphamide, but not CTLA4Ig, prolongs survival of fetal pig islet grafts in anti-T cell monoclonal antibody-treated NOD mice

Abstract: Fetal pig islets, xenografted after organ culture into non-immunosuppressed prediabetic NOD mice, are rejected within 10 days. Immunosuppression with anti-T cell (anti-CD4 and anti-CD3) monoclonal antibodies alone is highly effective in delaying graft rejection in this discordant model, but rejection eventually occurs, usually within 80 days, despite marked depletion of T cells. In an attempt to prevent rejection, we used cyclophosphamide (CP), a powerful anti-B cell agent, or CTL4Ig, an inhibitor of T-cell co-stimulation [via B7–1 (CD80) and B7–2 (CD86)], either given in combination with anti-CD4 (GK1.5) or anti-CD3 (KT3) MAb to the recipient mice. The addition of cyclophosphamide in a dose that significantly depleted B cells in peripheral blood was highly effective in preventing rejection, with xenografts surviving for at least 112 days, when the experiment was terminated. CTLA4Ig, administered alone, did not prevent delayed rejection (rejection occurred in <60 days) and, in contrast to CP, did not prevent delayed rejection when used in combination with GK1.5 and KT3 treatment. Thus, immunosuppressive agents found to be highly effective in other strains, e.g., CTLA4Ig and anti-T cell MAbs, had a lesser effect in NOD mice but the addition of an anti-B cell drug, CP, was useful. This finding may be applicable to patients with IDDM.     

Role of heme oxygenase‐1 in transplantation

Heme oxygenase‐1 (HO‐1) is the rate‐limiting enzyme in heme catabolism that converts heme to Fe++, carbon monoxide and biliverdin. HO‐1 acts anti‐inflammatory and modulates apoptosis in many pathological conditions. In transplantation, HO‐1 is overexpressed in organs during brain death, when undergoing ischemic damage and rejection. However, intentionally induced, it ameliorates pathological processes like ischemia reperfusion injury, allograft, xenograft or islet rejection, facilitates donor specific tolerance and alleviates chronic allograft changes. We herein consistently summarize the huge amount of data on HO‐1 and transplantation that have been generated in multiple laboratories during the last 15 years and suggest possible clinical implications and applications for the near future.     

Kinetics and character of xenoantibody formation in diabetic patients transplanted with fetal porcine islet cell clusters

Abstract: Porcine fetal islet-like cell clusters (ICC) were transplanted to 10 renal transplant patients suffering from long-standing type I diabetes. Since they had renal grafts, they were given immunosuppression with cyclosporine, prednisolone and azathioprine. Eight patients had the ICC injected intraportally and two had the ICC placed under the renal graft capsule. At the time of the xenotransplantation, ATG or 15-deoxyspergualin was given as an adjunct. Evidence of engraftment, as reflected by excretion of small amounts of porcine C-peptide into the urine, was observed in four of the patients. In all patients, irrespective of the type of immunosuppression given and whether graft function was established or not, specific xenoantibodies were formed. Titer increases in lymphocytotoxic antibodies occurred after 10 to 14 days with peak reactivity after 30 to 50 days. High titers of ADCC activity measured against porcine lymphoblasts were found in all patients. Titers were maintained at a high level for at least 100 days. Antibody titers were monitored against pig lymphocytes, erythrocytes and against pig membrane antigens solubilized from peripheral blood mononuclear cells, platelets and erythrocytes. Both IgM and IgG antibodies were formed with identical kinetics. There was no increase in the titers of alloantibodies, as evidenced by panel-reactive lymphocytotoxic antibodies. In all patients an increase in titers of isohemagglutinins was recorded, especially against blood group B antigens. Absorption studies showed that xenoreactivity present in healthy individuals could not be blocked by absorption with human RBC. However, in all transplanted patients, xenoreactivities against pig antigens were inhibited by absorption with human RBC, in particular with B-type RBC. These data show that the increase in isohemagglutinins was probably due to cross-reactivity with xenogeneic antigens. Using an ELISA assay, increased antibody titers were also recorded against purified pig MHC class I antigens. However, as is shown in the accompanying paper (next issue), these antibodies were probably not directed against protein determinants on the MHC molecules but rather against glycosylated side chains of these molecules.     

Expression of Galα(1,3)Gal by porcine islet cells and its relevance to xenotransplantation

Abstract: In pig-to-human transplantation, one of the major obstacles is the expression of Galα(1,3)Galactose by the endothelium of vascularized human tissues and the presence in all humans of IgG and IgM antibodies to this epitope: xenotransplantation would be followed by hyperacute rejection (HAR). However, the findings in endothelial cells of all vessels and the parenchyma of tissues such as kidney and liver do not extend to islet cells. Histological studies demonstrate that the adult pig islet (apart from endothelial cells) does not express Galα(1,3)Gal, nor do fresh neonatal or fetal pig islet cells; after tissue culture (under a variety of conditions) large amounts of Galα(1,3)Gal are expressed by the pig islet cells. However, double staining studies show that Gal+ cells do not secrete insulin, glucagon, or somatostatin and these cells may be spared from potential antigen antibody-mediated rejection after transplantation. The relevance of Gal expression in islet cells is discussed–short term studies–preferably in pig to Old World Monkey transplants could provide the answer to the relevance of Galα(1,3)Gal expression in islet cells. Thus far it appears that some islets can be destroyed by antibody; others are spared and it is important to determine the nature of the sparing mechanism.     

Pancreas and kidney transplantation: long‐term endocrine function

Mora M, Ricart MJ, Casamitjana R, Astudillo E, López I, Jiménez A, Fernández‐Cruz L, Esmatjes E. Pancreas and kidney transplantation: long‐term endocrine function.
Clin Transplant 2010: 24: E236–E240. © 2010 John Wiley & Sons A/S. Abstract: Objective: To describe the characteristics of metabolic control and beta‐cell function in the long‐term follow‐up of patients with type‐1 diabetes (T1D) who have undergone pancreas and kidney transplantation (PKTx). Patients and methods: Twelve patients (eight males/four females) with normal pancreas and kidney graft function for more than 15 yr were included. Patient age at the time of transplantation was 35.8 ± 6.9, with a duration of diabetes of 19.0 ± 4.6 yr and time on dialysis of 18.7 ± 12.4 months. In all the cases, bladder derivation was performed to drain exocrine secretion, with subsequent conversion to the intestinal tract in 42% of the patients. The functional evaluation was made at one, five, 10, and 15 yr after PKTx determining: glycosylated hemoglobin (HbA1c), oral glucose tolerance test (OGTT), measuring insulinemia, and anti‐GAD antibody. Results: Comparing the results between one and 15 yr after transplantation: (i) no differences were observed in either HbA1c (4.68% vs. 4.76%) or basal glycemia (71 vs. 79 mg/dL), but an increase was seen in the area under the curve (AUC) of glucose (11 983 vs. 15 875 mg/dL/120′, p = 0.02); (ii) a trend to a reduction in basal insulinemia (24 vs. 15 mU/L, p = 0.11) and a trend to a reduction in the AUC of insulinemia (8446 vs. 7057 mU/L/120′, p = 0.22) were observed. The OGTT was normal in six patients, intolerant in two and diabetic in four patients. No variations were seen in insulin resistance (FIRI, QUICKI). Anti‐GAD antibody became positive in one case. Conclusions: The results of this study demonstrate that pancreas transplantation has long‐term functional viability, being an essential strategy for the treatment of patients with T1D with end‐stage renal failure. Nevertheless, lesser response to OGTT can be expected suggesting certain deterioration in the functional capability of the pancreas graft during follow‐up.     

阻断糖尿病小鼠共刺激分子延长异种胰岛移植细胞功能

目的 阻断多种共刺激分子而诱导免疫耐受,以延长移植到糖尿病小鼠体内的猪胰岛细胞的功能.方法 将猪胰岛细胞移植于链脲佐菌素诱导的雄性C57BL/6糖尿病小鼠左肾被膜下,应用CTLA-4Ig融合蛋白、抗LFA-1抗体和抗CD40L抗体阻断多种其刺激分子,观察移植效果及移植物存活时间.结果 猪胰岛细胞移植后可降低糖尿病小鼠血糖;与对照组相比.实验组胰岛细胞存活时间明显延长,结论应用CTLA-4Ig融合蛋白、抗LFA-1抗体和抗CD40L抗体可延长异种移植胰岛细胞存活时间.     

Selective tyrosine kinase inhibition of insulin‐like growth factor‐1 receptor inhibits human and mouse breast cancer–induced bone cell activity,bone remodeling,and osteolysis

Insulin‐like growth factor 1 (IGF‐1) plays an important role in both bone metabolism and breast cancer. In this study, we investigated the effects of the novel IGF‐1 receptor tyrosine kinase inhibitor cis‐3‐[3‐(4‐methyl‐piperazin‐l‐yl)‐cyclobutyl]‐1‐(2‐phenyl‐quinolin‐7‐yl)‐imidazo[1,5‐a]pyrazin‐8‐ylamine (PQIP) on osteolytic bone disease associated with breast cancer. Human MDA‐MB‐231 and mouse 4T1 breast cancer cells enhanced osteoclast formation in receptor activator of NF‐κB ligand (RANKL) and macrophage colony‐stimulating factor (M‐CSF) stimulated bone marrow cultures, and these effects were significantly inhibited by PQIP. Functional studies in osteoclasts showed that PQIP inhibited both IGF‐1 and conditioned medium–induced osteoclast formation by preventing phosphatidylinositol 3‐kinase (PI3K)/protein kinase B (Akt) activation without interfering with RANKL or M‐CSF signaling. Treatment of osteoblasts with PQIP significantly inhibited the increase in RANKL/osteoprotegerin (OPG) ratio by IGF‐1 and conditioned medium and totally prevented conditioned medium–induced osteoclast formation in osteoblast–bone marrow (BM) cell cocultures, thereby suggesting an inhibitory effect on osteoblast–osteoclast coupling. PQIP also inhibited IGF‐1–induced osteoblast differentiation, spreading, migration, and bone nodule formation. Treatment with PQIP significantly reduced MDA‐MB‐231 conditioned medium–induced osteolytic bone loss in a mouse calvarial organ culture system ex vivo and in adult mice in vivo. Moreover, once daily oral administration of PQIP significantly decreased trabecular bone loss and reduced the size of osteolytic bone lesions following 4T1 intratibial injection in mice. Quantitative histomorphometry showed a significant reduction in bone resorption and formation indices, indicative of a reduced rate of cancer‐associated bone turnover. We conclude that inhibition of IGF‐1 receptor tyrosine kinase activity by PQIP suppresses breast cancer–induced bone turnover and osteolysis. Therefore, PQIP, and its novel derivatives that are currently in advanced clinical development for the treatment of a number of solid tumors, may be of value in the treatment of osteolytic bone disease associated with breast cancer. © 2013 American Society for Bone and Mineral Research.     

Rationale and timeliness for IL‐1β‐targeted therapy to reduce allogeneic organ injury at procurement and to diminish risk of rejection after transplantation

Wanderer AA. Rationale and timeliness for IL‐1β‐targeted therapy to reduce allogeneic organ injury at procurement and to diminish risk of rejection after transplantation.
Clin Transplant 2010: 24: 307–311. © 2010 John Wiley & Sons A/S. Abstract: Ischemia‐reperfusion injury (IRI) involving allograft transplantation and procured organs may in part be induced by stimulation of a newly described innate pro‐inflammatory immune system (i.e., NALP‐3‐inflammasome), which can cause secretion of IL‐1β and subsequent neutrophilic inflammation. Ischemia and/or hypoxia/anoxia can induce anaerobic metabolism with metabolic acidosis and subsequent development of danger signals known to stimulate IL‐1β secretion from the NALP‐3 inflammasome. Observations from IRI studies and hereditary auto‐inflammatory syndromes with NALP‐3 inflammasome mutations suggest that IL‐1β secretion can induce robust neutrophilic inflammation that is responsive to IL‐1β targeted therapy. Based on these observations and data from transplantation studies, it may be timely to consider commercially available IL‐1β targeted biologic therapy to improve allograft tolerance and viability of procured organs.     

24例无功能胰岛细胞瘤的诊治分析

目的总结无功能胰岛细胞瘤的外科诊治经验。方法回顾性分析24例无功能胰岛细胞瘤的临床资料。结果本组以腹部包块、腹痛、腹胀为主要首发症状。病灶主要位于胰头(62.5%)和胰尾部(20.8%)。2例为多发,均位于胰头。恶性肿瘤占45.8%,良性占54.2%,肿瘤最大径平均为6.5cm。胰体尾切除和胰十二指肠切除各占20.8%,单纯肿瘤切除占58.4%。术后主要并发症为胰瘘(16.7%)和腹腔出血(8.3%),均发生在单纯肿瘤切除的病例。良性肿瘤组中位生存期36.68个月,恶性肿瘤组的中位生存期15.67个月。结论无功能胰岛细胞瘤无特异症状;单纯肿瘤切除并发症发生率高,需行肿瘤所在部位的胰腺区域切除。     

Transplantation of human cells in the peritoneal cavity of immunodeficient mice for rapid assays of hepatitis B virus replication

Kumar M, Bandi S, Cheng K, Gupta S. Transplantation of human cells in the peritoneal cavity of immunodeficient mice for rapid assays of hepatitis B virus replication. Xenotransplantation 2011; 18: 380–389. © 2011 John Wiley & Sons A/S. Abstract: Background: Studies of natural hepatitis B virus infection must be restricted to humans or primates due to viral species‐specificity. Alternative hepadnavirus animal models, e.g., woodchuck hepatitis virus in captive woodchucks, are not convenient, while in transgenic mice hepatitis B virus or viral proteins are expressed permanently through integrated genomes. Availability of small animal models that are easily produced and permit rapid assays will be quite helpful. Aims: We examined whether transplantation of human cells in the peritoneal cavity of mice will generate an appropriate mass of cells with hepatitis B virus replication. Methods: HepG2 2.2.15 cells were transplanted intraperitoneally into NOD/SCID mice. Replication of hepatitis B virus and viral gene expression was determined by analysis of blood and transplanted tissues with viral DNA and hepatitis B core antigen expression. Interruption of viral replication was examined. Results: After intraperitoneal transplantation with microcarrier scaffolds, 2.2.15 cells engrafted and proliferated in the peritoneal cavity of NOD/SCID mice. Hepatitis B virus replicated in transplanted 2.2.15 cells as shown by hepatitis B core antigen expression. Moreover, viral particles were secreted into the blood. Hepatitis B virus replication was susceptible to conventional antiviral drug therapy, such as lamivudine, as well as experimental antiviral gene therapy with a synthetic mimic of an antiviral cellular microRNA. Conclusions: Intraperitoneal transplantation of human cells rapidly provided reservoirs of hepatitis B virus in mice. This simple xenotransplantation approach will be effective and convenient for studies of hepatitis B and other human viruses in vivo.     

Limited specificity of xenoantibodies in diabetic patients transplanted with fetal porcine islet cell clusters. Main antibody reactivity against α-linked galactose-containing epitopes

Abstract: The immunological specificity of antibodies formed as a result of xenotransplantation of fetal porcine islet-like cell clusters to diabetic patients was characterized. High titer increases were recorded against porcine cells, solubilized membrane fractions of porcine cells, and purified MHC class I antigens. However, titer increases were also noted against ssDNA and dsDNA and against pig thyroglobulin but not against actin, myoglobin, or haptenated BSA. Antibody titers against tetanus toxoid were unaffected. The reactivity against porcine RBC could be completely blocked by absorption with pig thyroglobulin. Since pig thyroglobulin contains the galαl-3gal antigen, the reactivity against RBC was most probably mainly due to antibodies against this oligosaccharide epitope. The reactivity against porcine mononuclear cells was only partially absorbed by pig thyroglobulin, indicating a heterogeneity of the clonal response. These conclusions were substantiated by data showing that the antigenic determinants on pig thyroglobulin were completely destroyed by treatment with α- but not with β-galactosidase. Further studies showed that immune reactivity against pig RBCs, platelets, islet-cells, endothelial cells and pig MHC class I molecules, caused by xenoimmunization, was almost completely blocked by either absorption of antibodies on a column of Sepharose beads coated with galα1-3gal or by pretreatment of the antigen fractions with α-galactosidase. Western blot experiments revealed that both the natural and xenoimmune antibodies reacted with a large number of different glycoproteins. There was no difference in heterogeneity of the response when comparisons were made between pre-and posttransplantation sera, nor was there any difference of patterns caused by IgM or IgG antibodies. Absorption studies revealed that this epitope was present in a large number of different glycoproteins, a conclusion verified by staining with the eluate from a thyroglobulin-immunosorbent column or with the eluate from the galα1-3gal-coupled Sepharose column. Our findings demonstrate that the xenoimmune response is mainly directed against oligosaccharide residues and that there is a limited clonal heterogeneity of antibodies in xenografted patients. There was no direct evidence of reactivity against any porcine proteins nor of specific immunization against porcine MHC peptides. The data form a basis for a future understanding of means to cope with and prevent the rejection of xenogeneic islet cells in man. We also suggest, based on the specificity found in xenoimmunized patients sera, that a major part of naturally occurring antibodies might be specifically reactive with carbohydrate antigens.