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1996-02-26
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Document 0619
DOCN M9620619
TI [Human fetal pancreatic islet transplantation in insulin-dependent
diabetics: possibilities of early detection of transplant destruction]
DT 9602
AU Djordjevic PB; Brkic S; Lalic NM; Zamaklar M; Dragasevic M; Radovic Z;
Popovic S; Banovic D; Dimitrijevic V; Savic K; et al; Institute for
Endocrinology, Diabetes and Metabolic Diseases,; University Clinical
Center, Belgrade, Yugoslavia.
SO Glas Srp Akad Nauka [Med]. 1994;(44):83-8. Unique Identifier : AIDSLINE
MED/96021697
AB The factors determining the outcome of human fetal islet transplantation
in patients with insulin-dependent diabetes mellitus (IDDM) remain
unclarified. In this study we analysed the ratio between
immunoregulatory lymphocyte subpopulations in order to search for a
possible marker of the immune destruction of transplanted islets. Human
fetal islets were isolated by collagenase digestion, cultured for 14
days at 37 degrees C, 5% CO2, and implanted under fascia of m. rectus
abdominis in 7 IDDM patients (5 pancreata per patient). After
transplantation we evaluated simultaneously the level of metabolic
control through HbA1c values determined by chromatography, the capacity
of insulin secretion through the C-peptide levels (determined by
radioimmunoassay) before and 6 minutes after 1 mg glucagon i.v.
stimulation, and the ratio between CD4+ and CD8+ lymphocytes determined
by immunofluorescence using monoclonal antibodies. We found that
metabolic control after transplantation was improved together with the
decrease of the insulin daily dose, and the improvement was simultaneous
to the increase of both basal and glucagon-stimulated C-peptide levels.
Four months after transplantation we detected a remarkable decrease in
the secretion capacity, accompanied by the necessity for an increase in
daily insulin dose to maintain optimal metabolic control. However, the
loss of islet function was preceded by the increase in CD4+/CD8+ ratio,
thus reflecting the presumable accumulation of CD4+ inducer
T-lymphocytes. When the islet secretion capacity was destroyed, we found
a decrease in CD4+/CD8+ ratio, reflecting the recruitment of CD8+
effector cells.(ABSTRACT TRUNCATED AT 250 WORDS)
DE Adult CD4-CD8 Ratio Diabetes Mellitus,
Insulin-Dependent/IMMUNOLOGY/PHYSIOPATHOLOGY/ *SURGERY English
Abstract Female *Fetal Tissue Transplantation *Graft Survival Human
Insulin/SECRETION Islets of Langerhans/EMBRYOLOGY/SECRETION *Islets of
Langerhans Transplantation Male JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).