SDF-1/CXCR4轴在骨髓间充质干细胞移植促进胰岛再生中的作用

目的 观察同种异体骨髓间充质干细胞(MSCs)移植入受体后,基质细胞衍生因子(SDF)-1/CXCR4轴在促进残存胰岛及其周围新生血管增殖中的作用.方法 对大鼠MSCs进行体外培养、鉴定.链脲佐菌素(STZ)诱导的糖尿病大鼠随机分为A组(MSCs移植组)、B组(MSCs移植+SDF-I/CXCR4轴阻断剂AMD组)和C组(糖尿病对照组),另设D组(正常大鼠对照组).移植MSCs后第30天取出各组大鼠胰腺和血清,胰腺组织采用苏木素-伊红(HE)染色和免疫组织化学法观察CD31、增殖细胞核抗原(PCNA)、胰腺干细胞标志物(PDX)-1在胰腺组织的表达水平.血糖仪检测血糖水平、放免法检测胰岛素水平、酶联免疫吸附试验(ELISA)检测SDF-1水平.结果 (1)A组残存胰岛周围可见新生血管,CD31、PCNA、PDX-1染色阳性率分别为(71.2±5.3)%、(76.5±4.5)%、(69.8±6.7)%;B组残存胰岛周围基本未见新生血管,CD31、PCNA、PDX-1染色阳性率分别为(7.4±2.1)%、(5.5±3.7)%、(8.8±2.9)%,两组比较差异有统计学意义(P＜0.05).(2)移植后第25天,A组血糖浓度基本正常,低于B组和C组,而胰岛素水平明显高于B组和C组(P＜0.05).(3)A组与B组血清SDF-1水平差异无统计学意义(P＞0.05),但都明显高于C组(P＜0.05).结论 MSCs促进胰岛再生和新生血管形成,AMD3100能抑制MSCs的作用,进而提示SDF-1/CXCR4轴在胰岛再生和血管形成中具有重要作用.

Abstract：

Objective To investigate the role of stromal cell derived factor-1 (SDF-1)/CXCR4axis in recipients' remnant islets regeneration and neovascularization after the transplantation of allogeneic bone marrow mesenchymal stem cells (MSCs). Methods MSCs were isolated from SD rats, cultured in vitro and identified by testing the phenotypes with flow cytometry ( FCM ). The diabetic rats induced by streptozotozin were randomly divided into group A ( MSCs transplant group), group B ( MSCs transplant +AMD group) and group C ( DM control group). Group D serve as the normal control. The pancreata were removed and blood serum was retrieved from each group simultaneously at the 13th day after MSCs transplant. The expression of CD31, proliferating cell nuclear antigen (PCNA) and PDX-1 in each group of pancreas tissue was detected by using immunohistochemistry, and the morphological changes in the isletswere observed by Hematoxylin and Eosin (HE) staining. Serum glucose and insulin levels were determined by blood glucose monitor, radioimmunoscintigraphy, and SDF-1 in serum was by enzyme linked immunosorbent assay (ELISA). Results Neovascularization was observed in the remnant islets of the recipient pancreatic tissue and CD31 -positive cells (71.2 ± 5.3 ) %, PCNA-positive cells ( 76. 5 ± 4. 5 ) %, PDX-1-positive cells (69. 8 ±6. 7)% were highly expressed in group A. As compared with group A, seldom-positive cells[CD31 (7.4±2. 1)%, PCNA (5.5 ±3.7)% and PDX-1 (8.8 ±2.9)%]and rarely neovascularization were observed in group B (P ＜0. 05 ). Serum glucose level in group A was lower than that in group B and group C, but serum insulin level in group A was significantly higher than that in group B and group C (P ＜ 0. 05 ). There was no significant difference between group A and group B in serum SDF-1level ( P ＞ 0. 05 ), but that was higher in groups A and B than in group C ( P ＜ 0. 05 ). Conclusion Obviously, MSCs promote recipient neovascularization surrounding the islets, which enhances the proliferation and regeneration of remnant islets. AMD 3100 has the function of intervening SDF-1/CXCR4 axis,which inhibits the effect of MSCs on promoting islets regeneration. It is suggested that SDF-1/CXCR4 axis may play an important role in vascularization and islets regeneration.     

子鼠胰腺干细胞与胰岛联合移植治疗糖尿病

目的 探讨利用子鼠胰腺干细胞与胰岛联合移植保护移植胰岛,提高糖尿病移植疗效的可行性.方法 分离纯化孕16 d SD大鼠子鼠:胰腺干细胞培养传代,行Nestin免疫组织化学及流式细胞术鉴定;分离纯化SD大鼠胰岛,分联合移植组(10只)、单独移植组(10只)及正常对照组(10只),分别将2×105个子鼠:胰腺干细胞与800个胰岛和单纯800个胰岛移植至糖尿病大鼠模型左肾包膜下,定期监测各组大鼠血糖情况及留取血浆ELISA测胰岛素含量,观察胰岛存活时间.结果 子鼠:胰腺干细胞培养传代3代后细胞涂片免疫组织化学示存在Nestin阳性细胞,流式细胞术测定nestin阳性细胞含量占74.1%.联合移植组大鼠均于术后第3天起血糖开始下降,血浆胰岛素水平逐渐升高,术后5 d内血糖可降至正常[(5.4±0.6)mmol/L],血浆胰岛素达到正常水平[(509.8±16.6)ng/L],胰岛存活时间(18.2±2.4)d;单独移植组大鼠血糖可于术后1周内降至正常[(6.1±0.9)mmol/L],胰岛存活时间(14.4±2.1)d;两组胰岛存活时间差别有统计学意义(P《0.05).结论 子鼠胰腺干细胞与胰岛联合移植可保护胰岛功能,延长胰岛体内存活时间,提高移植疗效.     

骨髓间充质干细胞移植对糖尿病大鼠的治疗作用

目的 观察同种大鼠骨髓间充质干细胞(BMSC)移植对糖尿病的治疗作用及其可能机制.方法 分离、培养和扩增供者(3～4周龄的SD大鼠)的BMSC,将成年SD大鼠分为正常对照组(12只)和糖尿病组(44只,制作糖尿病模型);糖尿病组大鼠又分为不移植对照组(12只)和移植组(32只).将分离纯化的同种大鼠BMSC经移植组大鼠尾静脉植入体内,每只大鼠移植BMSC约3×10~6个.移植后动态观察各组的血糖和胰岛素水平;移植后28 d制备胰腺组织切片,通过激光共聚焦显微镜观察移植的BMSC对内源性胰岛细胞再生的影响.结果 正常对照组血糖在4.0 mmol/L左右波动;不移植对照组血糖显著升高,维持在23～27 mmol/L;移植组血糖明显降低,术后72 h平均血糖值为(11.7±2.4)mmol/L,并维持稳定至35 d[血糖值(15.4±6.3)mmol/L].移植组血清胰岛素水平较不移植对照组明显增高,术后12 d时分别为(0.90±0.14)μg/ml和(0.35±0.06)μg/ml(P<0.01),但仍明显低于正常对照组的(1.32±0.14)μg/ml,差异有统计学意义(P<0.05).正常对照组大鼠胰腺组织切片内胰岛素阳性细胞聚集,但增殖的细胞极少,约为(11±6)个/mm~2,内源性增生的胰岛素阳性细胞约(7±4)个/mm~2.不移植对照组大鼠胰腺组织中胰岛素阳性细胞较正常对照组少,但存在明显的增生.增殖细胞约(25±4)个/mm~2.其中内源性增生的胰岛素阳性细胞约(13±5)个/mm~2,与正常对照组比较,差异有统计学意义(P<0.05).移植组胰岛体积较不移植对照组增大,增殖细胞和内源性增生的胰岛素阳性细胞均明显增多,分别为(45±9)个/mm~2和(23±11)个/mm~2,与正常对照组、不移植对照组之间比较,差异均有统计学意义(P<0.01).结论 糖尿病大鼠经同种BMSC移植后,可能通过促进内源性胰岛细胞新生发挥治疗作用,这可能为糖尿病的治疗提供一条新的途径.     

同种异体胰岛及胰腺干细胞来源的胰岛样结构序贯移植治疗糖尿病

目的 观察同种异体大鼠胰岛及胰腺干细胞来源的胰岛样结构序贯移植在糖尿病治疗中的作用.方法 分离胰腺组织获得胰岛及胰腺导管上皮细胞,将具有干细胞潜能的胰腺导管上皮细胞在体外培养27d.将新鲜分离的胰岛(200±50)个及诱导分化2周的胰腺干细胞来源的胰岛样结构(2×106)个序贯移植到糖尿病大鼠的肾被膜下观察大鼠的血糖及生存情况.结果 将胰岛及胰腺干细胞来源的胰岛样结构序贯移植到同一糖尿病大鼠3周后血糖仍在5 mmol/L水平,对照组血糖无明显下降.结论 胰腺干细胞可诱导分化为分泌胰岛素的胰岛样结构,胰岛及胰腺干细胞来源的胰岛样结构序贯移植对大鼠糖尿病有治疗作用.     

骨髓间充质干细胞移植可促进移植胰岛周围新生血管形成

目的探讨胰岛移植联合骨髓间充质干细胞(MSC)移植能否促进移植胰岛周围新生血管形成。方法以非肥胖糖尿病(NOD)小鼠作为受体,将NOD小鼠随机分为4组,联合移植组(6只)、单独胰岛移植组(6只)、单独MSC移植组(6只)、假性移植组(3只)。观察各组NOD小鼠移植后血糖和存活率的变化;采用5-乙炔基-2’脱氧尿苷(Ed U)及d UTP缺口末端标记(TUNEL)方法,在胰岛移植后1、2、4周检测单独胰岛移植组和联合移植组移植胰岛的增殖与凋亡情况;采用光学显微镜(光镜)直接观察、组织化学及免疫组织化学的方法观察并定量分析,移植术后2、4、8周单独胰岛移植组和联合移植组移植胰岛的周围新生血管密度。结果 MSC联合移植与胰岛单独移植均能明显改善移植后小鼠的血糖水平,提高NOD小鼠的存活率。MSC联合移植可促进胰岛细胞再生,减少细胞凋亡。联合移植组移植胰岛周围血管密度明显大于单独胰岛移植组。结论 MSC可以促进移植胰岛周围新生血管生成,增加移植胰岛的血供,保护移植胰岛的功能与活性。     

激活型Akt1转染大鼠胰岛对移植物凋亡和再血管化的影响

目的 探讨腺病毒介导激活型蛋白激酶B(Akt1)基因(Adv-CA-Akt1)转染大鼠胰岛对同种糖尿病大鼠胰岛移植物凋亡和再血管化的影响.方法 分离纯化Wistar大鼠胰岛,转染Adv-CA-Akt1.36只糖尿病Wistar大鼠完全随机均分为3组: Adv-CA-Akt1组(Adv-CA-Akt1转染的胰岛移植); Adv-LacZ组(Adv-LacZ转染的胰岛移植); 未转染组(单纯胰岛移植).术后每日测血糖,隔日测血清胰岛素浓度,术后10 d行静脉糖耐量试验(IVGTT)观察胰岛功能; HE染色和胰岛素免疫组化检测胰岛功能,细胞凋亡原位检测胰岛凋亡,CD31免疫组化计数微血管密度(MVD).结果 Adv-CA-Akt1组大鼠血糖术后2 d恢复正常,Adv-LacZ组和未转染组血糖虽下降但仍高于正常; Adv-CA-Akt1组术后各时相血清胰岛素水平明显高于其他2组(P＜0.05).IVGTT示Adv-CA-Akt1组血糖下降较快,60 min恢复至空腹水平; 另2组下降慢,60 min仍未恢复至空腹水平.术后3 d,Adv-CA-Akt1组肾被膜下存活胰岛细胞数量多,胰岛素免疫组化证明为有功能的胰岛.Adv-CA-Akt1组胰岛凋亡率比Adv-LacZ组和未转染组降低约25%; 术后12 d,Adv-CA-Akt1组MVD比Adv-LacZ组及未转染组明显增高(P＜0.05).结论 激活型Akt1转染大鼠胰岛能够抑制胰岛细胞凋亡,提高胰岛β细胞功能,促进移植物早期再血管化.     

骨髓来源细胞移植对糖尿病小鼠胰岛功能的影响

目的 观察骨髓来源细胞(BMDCs)移植对糖尿病小鼠胰岛功能的影响.方法 建立糖尿病小鼠模型并分成两组:实验组小鼠(n=8)通过尾静脉移植BMDCs;对照组小鼠(n=8)通过尾静脉注射磷酸盐缓冲液(PBS).观察两组小鼠血糖的变化、胰岛数量、胰腺组织形态学特征及相关标记物的表达.结果 与对照组比较,实验组小鼠移植后第4周血糖出现明显下降(20.7±5.2)比(27.1±1.4)mmol/L,P＜0.05,并持续下降至第6周(16.9±6.0)比(27.7±0.3)mmol/L,P＜0.01,胰岛数目显著增加(22.9±4.8)比(11.6±5.2)个,P＜0.01;实验组小鼠胰岛周围和胰岛内发现绿色荧光蛋白(GFP)阳性细胞,部分GFP阳性细胞同时表达CD34,但未发现同时表达GFP和insulin的细胞.结论 BMDCs移植能促进糖尿病小鼠胰岛的修复和再生,但BMDCs在糖尿病小鼠体内不能转分化为胰岛β细胞,CD34阳性细胞在损伤胰岛修复和再生的过程中起重要作用.     

激活型Akt1转染大鼠胰岛联合免疫抑制剂在异种胰岛移植中的应用

目的 探讨腺病毒载体介导激活性Akt1基因(Adv-CA-Akt1)转染大鼠胰岛对异种移植胰岛功能和存活的影响.方法 以BALB/C糖尿病小鼠为受体,分离纯化雄性Wistar大鼠胰岛,体外培养,Adv-CA-Akt1转染后异种胰岛移植.受体小鼠分3组,实验组:Adv-CA-Akt1转染的大鼠胰岛体外培养24 h,小鼠肾被膜下移植,并口服环孢素A(CsA)30 mg·kg-1·d-1;CsA组:未转染胰岛移植,同剂量环孢素口服;对照组:单纯胰岛移植.每只接受300胰岛当量(IEQs)移植.检测术后血糖,移植物存活时间及组织病理学.结果 实验组和CsA组术后2 d血糖即降至正常,胰岛功能存活时间分别为(21.0±3.65)d和(9.0±2.54)d,而对照组血糖短暂下降后再次升高,胰岛功能存活时间(4.2±2.6)d.实验组小鼠生存时间为(31.0±5.67)d比CsA组(17.0±3.35)d和对照组(10.0±1.52)d明显延长,三组比较差异有统计学意义(P<0.05);胰岛素免疫组化染色实验组.肾被膜下见较多有功能胰岛细胞团,而CsA组和对照组胰岛素染色阳性细胞数减少.结论 Adv-CA-Akt1转染大鼠胰岛联合应用免疫抑制剂,可提高胰岛功能,延长异种胰岛移植物存活时间.     

血管内皮生长因子促进大鼠的移植胰岛再血管化并提高其存活率

目的探讨血管内皮生长因子（VEGF）对大鼠的移植胰岛再血管化及对其存活率和功能的影响。方法构建质粒pIRES2-EGFP／VEGF165，以脂质体法在体外转染大鼠（供者）的血管内皮细胞。流式细胞术检测转染效率；免疫组织化学染色检测VEGF的表达。将糖尿病大鼠（受者）随机分为3组，每组10只。对照组：于肾被膜下单纯移植供者的300当量胰岛；实验组和空白转染组除移植供者的300当量胰岛外，分别加入供者的1×10^6个转染了质粒pIRES2-EGFP／vEGF165的血管内皮细胞和未经转染的正常血管内皮细胞。移植后监测受者的血糖及血清胰岛素水平。术后第14天，取受者肾脏，行HE染色及Insulin-6、VEGF和CD34免疫组织化学染色。结果血管内皮细胞中VEGFm的转染效率为13．06％。实验组供者的血管内皮细胞胞核和胞浆中均有VEGF表达。实验组受者于移植术后第3天血糖及胰岛素水平恢复正常；对照组和空白转染组虽有所改善，但未恢复到正常水平，与实验组相比，差异有统计学意义。实验组受者肾被膜下可见成团胰岛，Insulin-6免疫组织化学染色呈阳性，周围及内部有大量内皮细胞；VEGFm及CD34免疫组织化学染色呈阳性。对照组和空白转染组肾被膜下的细胞团中心细胞较少，部分被纤维组织代替，内部仅有少量CD34染色阳性的内皮细胞；Insulin-6免疫组织化学染色仅有少量细胞染成棕黄色；VEGF165免疫组织化学染色呈阴性。结论供者的胰岛与转染了VEGF165的血管内皮细胞共同移植给受者可以促进移植胰岛的再血管化，提高其存活率，并使其功能恢复正常。     

不同微环境对骨髓间充质干细胞分化为产胰岛素细胞的影响

目的 观察不同的微环境对大鼠骨髓间充质干细胞(MSCs)体外分化成为产胰岛素细胞(IPCs)的影响.方法 采用贴壁法分离纯化大鼠MSCs,用不同的微环境进行诱导,对照组诱导剂为含有角朊细胞生长因子、ITS、尼克酰胺的无血清DMEM/F12培养基、实验组在对照组基础上添加胰腺条件培养液;对诱导后细胞进行光、电镜观察,双硫腙和免疫细胞化学进行鉴定,并进行体外葡萄糖刺激实验,测定细胞分泌胰岛素及C-肽功能.结果 实验组及对照组均可诱导分化为IPCs,但实验组分化而成的IPCs在数量及功能上均高于对照组.结论 大鼠胰腺提取物模拟的微环境能促进大鼠MSCs体外诱导分化为较高质量的IPCs.     

骨髓间充质干细胞移植途径对胰岛移植物免疫排斥反应的影响

目的:探讨骨髓间充质干细胞(MSC)与胰岛共移植对诱导胰岛移植物免疫耐受的作用,并比较MSC不同途径移植的效果。方法:SD大鼠和Lewis大鼠分别作为供、受体。取SD大鼠股骨,贴壁培养法分离和扩增MSC,胶原酶V分离胰岛。应用链脲佐菌素制备Lewis大鼠糖尿病模型后,将其随机均分为A组(将BrdU标记的MSC与胰岛经门静脉混合输入),B组(将胰岛经门静脉输入,BrdU标记的MSC经尾静脉输入),C组(胰岛经门静脉输入,联合应用环孢素A)和D组(单纯胰岛门静脉移植)。观察各组术后血糖变化,比较各组胰岛移植物存活时间。术后第7天切取各组部分存活大鼠肝脏、胸腺、脾脏行免疫组化染色观察MSC归巢位置。结果:A,B两组大鼠术后正常血糖维持时间最长,C组次之,D组最短;各组胰岛存活时间A组为(12.1±2.3)d,B组为(8.6±1.4)d,C组为(13.2±1.9)d,D组为(2.2±0.6)d;MSC归巢部位观察显示,A组BrdU阳性的MSC主要分布于肝脏,并在植入胰岛周围形成"类微囊化效应",B组BrdU阳性的MSC主要分布于胸腺、脾脏。结论:MSC与胰岛共移植能诱导胰岛移植物免疫耐受,且MSC和胰岛混合经门静脉移植效果优于胰岛门静脉移植联合MSC外周静脉移植。     

Revascularization and function of pancreatic islet isografts in diabetic rats following transplantation

In pancreatic islet transplantation, revascularization is crucial for the graft's survival and function. In this study, the endothelium of isolated islets and revascularization and function of islet isografts in diabetic rat were investigated. Islets were isolated from Lewis rats by collagenase digestion method and were examined using immunohistochemistry (CD31 stain) on days 0, 1, 3, and 7 after isolation. The number of CD31-positive cells in these isolated islets was counted (mean +/- SD %). Isografts (freshly isolated islets: group A, and islets cultured for 7 days: group B) transplanted in the renal subcapsule of streptozotocin-induced diabetic Lewis rats were examined using immunohistochemistry (CD31 stain) on days 3, 5, and 7 after transplantation. Intravenous glucose tolerance tests (IVGTT) were performed on days 3 and 7 after transplantation. The number of CD31-positive cells in the isolated islets on days 0, 1, 3, and 7 after isolation were: 17.3 +/- 4.1%, 8.2 +/- 0.7%, 2.1 +/- 0.8%, and 0.8 +/- 0.5%, respectively (p < 0.05). On day 5 after transplantation, CD31-positive cells were not detected in group A and B grafts, but were detected in both groups in periphery of the islets. On day 7, CD31-positive microvessels were present throughout the entire graft. IVGTT values in groups A and B on days 3 and 7 after transplantation did not show significant differences. In renal subcapsular isografts in diabetic rats, revascularization into islet grafts occurs from the surrounding host tissue 5 days after transplantation, but has no influence on the response to glucose during this period.     

小鼠骨髓间充质干细胞减轻胰岛移植物排斥反应的作用

目的 探讨同种异基因小鼠骨髓间充质干细胞(MSC)与胰岛联合移植对胰岛移植物的免疫调节作用.方法 将18只糖尿病模型小鼠随机分成3组:(1)糖尿病组,不进行任何移植;(2)胰岛移植组,在无菌操作下将10μl纯化后的200个胰岛移植于受者的左肾包膜下;(3)胰岛+MSC移植组,除与胰岛移植组进行相同的移植外,还在胰岛移植前3、2、0d经受者尾静脉分别注射1×106个MSC.移植后,连续监测非空腹血糖至第30 d;第14和28 d对移植部位的左肾进行组织病理学观察;采集外周血进行免疫荧光染色,流式细胞术分析TH1/TH2、Tc1/Tc2细胞的比值、初始和记忆T淋巴细胞的变化、以及骨髓来源的树突状细胞(DC)成熟度和功能的变化.结果 与胰岛移植组比较,胰岛+MSC移植组血糖明显降低,移植部位炎症细胞浸润明显减轻,移植物的存活时间延长;TH1和Tc1细胞明显下降,TH2和Tc2细胞升高,TH1/TH2和Tc1/Tc2细胞比值显著下降;初始T淋巴细胞和记忆T淋巴细胞下调;DC成熟度降低,分泌白细胞介素12(IL-12)的能力下降.结论 MSC与胰岛联合移植可通过对T淋巴细胞和树突状细胞的免疫调节作用,减轻胰岛移植物的排斥反应,从而延长移植胰岛的存活时间.     

体外诱导骨髓间充质干细胞向肾小管上皮样细胞分化

目的 观察不同条件下骨髓间充质干细胞（MSC）体外诱导分化为肾小管上皮样细胞的差异。 方法 抽取SD大鼠的骨髓,经密度梯度离心分离,联合贴壁筛选法获取纯化的MSC。以流式细胞仪鉴定间充质干细胞表面标志。取扩增3代的MSC分组培养：（1）对照组：用含胎牛血清培养基;（2）全反式维甲酸（ATRA）组：胎牛血清+缺血再灌注肾脏匀浆上清+ATRA;（3）联合诱导组：胎牛血清+缺血再灌注肾脏匀浆上清+ATRA+表皮生长因子（EGF）+骨形成蛋白（BMP-7）。诱导7 d后,倒置显微镜下观察细胞形态变化;化学染色检测细胞碱性磷酸酶表达;免疫细胞化学法检测细胞角蛋白18（cytokeratin-18）、E钙黏蛋白(E-cadherin)的表达。 结果 流式细胞仪显示,体外分离培养的第3代MSC,CD44阳性细胞表达率为97.8%±0.9%;CD90阳性细胞表达率为96.8%±1.4%;CD29阳性细胞表达率为97.6%±2.4%;而CD11b/c阳性细胞表达率为13.2%±0.6%; CD34阳性细胞表达率为1.2%±0.5%。诱导7 d后,与对照组长梭形细胞相比,ATRA组部分细胞为圆形、短梭形单层排列;联合诱导组的大部分细胞为圆形、短梭形,细胞密集处呈鹅卵石样排列。碱性磷酸酶染色显示,对照组细胞为阴性;ATRA组部分细胞阳性;联合诱导组阳性细胞数明显增多。免疫细胞化学显示,ATRA组和联合诱导组细胞cytokeratin-18阳性表达率分别为29.47%±1.08%和47.52%±2.13%,显著高于对照组（P ＜ 0.05）;E-cadherin阳性表达率分别为14.88%±2.46%和36.15%±1.13%,也显著高于对照组（P ＜ 0.05）。 结论 在体外模拟的急性肾衰竭微环境中加入ATRA可诱导MSC部分分化为肾小管上皮样细胞。联合EGF、BMP-7共同诱导能进一步促进MSC向肾小管上皮样细胞分化。     

Long-term islet allograft function in the absence of chronic immunosuppression: a case report of a nonhuman primate previously made tolerant to a renal allograft from the same donor

Development of mixed chimerism by donor bone marrow transplantation (DBMT) has led to long-term tolerance of solid organ allografts in nonhuman primates. As an initial attempt to extend this approach to cellular transplant, islet transplant from the same donor was attempted in the recipient previously made tolerant to a kidney allograft.METHODS: After the conditioning with ATG, total body irradiation, thymic irradiation, and splenectomy, DBMT was performed followed by 4 weeks of cyclosporine. Kidney transplantation and native nephrectomies were subsequently performed on day 89. After 2.8 years of DBMT, diabetes was induced by streptozocin (STZ) and islets from bone marrow and kidney donor were transplanted without immunosuppression. RESULTS: After DBMT, the recipient developed chimerism and no evidence of kidney rejection for more than 1000 days. STZ induced diabetes was reversed after the islet transplantation. Islet biopsies demonstrated insulin staining without rejection. Although the recipient became diabetic 300 days after islet transplantation, viable transplanted islets were found in the liver and under the kidney capsule without any evidence of rejection. CONCLUSION: Tolerance with a nonmyeloablative conditioning can allow successful pancreatic islet transplantation without immunosuppression. Because no histological evidence of rejection was identified, recurrent diabetes is presumed to be inadequate islet mass.     

Intraislet endothelial cells contribute to revascularization of transplanted pancreatic islets

Pancreatic islet transplantation is an emerging therapy for type 1 diabetes. To survive and function, transplanted islets must revascularize because islet isolation severs arterial and venous connections; the current paradigm is that islet revascularization originates from the transplant recipient. Because isolated islets retain intraislet endothelial cells, we determined whether these endothelial cells contribute to the revascularization using a murine model with tagged endothelial cells (lacZ knock-in to Flk-1/VEGFR2 gene) and using transplanted human islets. At 3-5 weeks after transplantation beneath the renal capsule, we found that islets were revascularized and that the transplant recipient vasculature indeed contributed to the revascularization process. Using the lacZ-tagged endothelial cell model, we found that intraislet endothelial cells not only survived after transplantation but became a functional part of revascularized islet graft. A similar contribution of intraislet endothelial cells was also seen with human islets transplanted into an immunodeficient mouse model. In the murine model, individual blood vessels within the islet graft consisted of donor or recipient endothelial cells or were a chimera of donor and recipient endothelial cells, indicating that both sources of endothelial cells contribute to the new vasculature. These observations suggest that interventions to activate, amplify, or sustain intraislet endothelial cells before and after transplantation may facilitate islet revascularization, enhance islet survival, and improve islet transplantation.     

Enhanced effect of human mesenchymal stem cells expressing human TNF‐αR‐Fc and HO‐1 gene on porcine islet xenotransplantation in humanized mice

Background

Porcine islet xenotransplantation is considered an attractive alternative treatment for type 1 diabetes mellitus. However, it is largely limited because of initial rejection due to Instant Blood‐Mediated Inflammatory Reaction (IBMIR), oxidative stress, and inflammatory responses. Recently, soluble tumor necrosis factor‐ɑ receptor type I (sTNF‐αR) and heme oxygenase (HO)‐1 genes (HO‐1/sTNF‐αR) have been shown to improve the viability and functionality of porcine islets after transplantation.

Methods

In this study, genetically modified mesenchymal stem cells (MSCs) expressing the HO‐1/sTNF‐αR genes (HO‐1/sTNF‐αR‐MSC) were developed using an adenoviral system, and porcine islet viability and function were confirmed by in vitro tests such as GSIS, AO/PI, and the ADP/ATP ratio after coculturing with HO‐1/sTNF‐αR‐MSCs. Subsequently, isolated porcine islets were transplanted underneath the kidney capsule of diabetic humanized mice without MSCs, with MSCs or with HO‐1/sTNF‐αR‐MSCs.

Results

According to the results, the HO‐1/sTNF‐αR‐MSC‐treated group exhibited improved survival of porcine islets and could reverse hyperglycemia more than porcine islets not treated with MSCs or islets cotransplanted with MSCs. Moreover, the HO‐1/sTNF‐αR‐MSC group maintained its morphological characteristics and the insulin secretion pattern of transplanted porcine islets similar to endogenous islets in immunocompetent humanized mice.

Conclusions

Our results suggest that HO‐1/sTNF‐αR‐MSCs are efficient tools for porcine islet xenotransplantation, and this study may provide basic information for pre‐clinical animal models and future clinical trials of porcine islet xenotransplantation.     

Cotransplantation of preactivated mesenchymal stem cells improves intraportal engraftment of islets by inhibiting liver natural killer cells in mice

The activation of natural killer (NK) cells in the liver inhibits engraftment of intraportally transplanted islets. We attempted to modulate the activity of NK cells by cotransplanting mesenchymal stem cells (MSCs) with islets in mice. We first investigated the ability of MSCs to secrete prostaglandin E2 , a predominant inhibitor of NK cell function, in various combinations of inflammatory cytokines. Notably, we found that prostaglandin E2 production was partially delayed in MSCs activated by inflammatory cytokines in vitro, whereas liver NK cells were activated early after islet transplant in vivo. Accordingly, preactivated MSCs, but not naive MSCs, substantially suppressed the expression of activation markers in liver NK cells after cotransplant with islets. Similarly, cotransplant with preactivated MSCs, but not naive MSCs, markedly improved the survival of islet grafts. These results highlight MSC cotransplant as an effective and clinically feasible method for enhancing engraftment efficiency.