TLR4 Mediates Early Graft Failure After Intraportal Islet Transplantation

We have previously shown that islet emboli in the portal vein block blood flow and induce local inflammatory reaction, resulting in functional loss of islet grafts following intraportal transplantation. This study was designed to test whether Toll‐like receptor (TLR) activation mediates early islet graft failure. Syngeneic islet grafts were transplanted into chemically induced diabetic mice, and TLR deficient mice were used as donors and/or recipients of islet grafts. Islet viability, proinflammatory cytokines, high‐mobility group box‐1 (HMGB1) and NF‐κB activation were analyzed by bioluminesce imaging (BLI), quantitative RT‐PCR (qRT‐PCR) and histology. Early islet graft failure was observed in mice with intraportal islet engrafts with increased proinflammatory cytokines, HMGB1 expression, NF‐κB activation, caspase‐3 and TUNEL positive cells. Deficiency of TLR4 in donor, but not in recipient, inhibited NF‐κB activation, reduced proinflammatory cytokines and improved viability of islet grafts. Blockade of HMGB1 with anti‐HMGB1 monoclonal antibody (mAb, 2g7) inhibited inflammatory reactions, as evidenced by reduced TNFα and IL‐1ß production, and improved islet viability. We conclude that TLR4 activation mediates early graft failure following intraportal islet transplantation. Inhibition of TLR4 activation represents a novel strategy to attenuate early graft failure following intraportal islet transplantation.