Gysemans C, Van Etten E, Overbergh L, Verstuyf A, Waer M, Bouillon R, Mathieu C
Laboratory for Experimental Medicine and Endocrinology (LEGENDO), Katholieke Universiteit Leuven, Belgium.
Clin Exp Immunol. 2002 May;128(2):213-20. doi: 10.1046/j.1365-2249.2002.01825.x.
Autoimmune diabetes recurrence is in part responsible for islet graft destruction in type 1 diabetic individuals. The aim of the present study was to design treatment modalities able to prevent autoimmune diabetes recurrence after islet transplantation in spontaneously diabetic NOD mice. In order to avoid confusion between autoimmune diabetes recurrence and allograft rejection, we performed syngeneic islet transplantations in spontaneously diabetic NOD mice. Mice were treated with mouse interferon-beta (IFN-beta, 1 x 105 IU/day), a new 14-epi-1,25-(OH)2D3-analogue (TX 527, 5 microg/kg/day) and cyclosporin A (CsA, 7.5 mg/kg/day) as single substances and in combinations. Treatment was stopped either 20 days (IFN-beta and CsA) or 30 days (TX 527) after transplantation. Autoimmune diabetes recurred in 100% of control mice (MST 11 days). None of the mono-therapies significantly prolonged islet graft survival. Combining CsA with TX 527 maintained graft function in 67% of recipients as long as treatment was given (MST 31 days, P < 0.01 versus controls). Interestingly, 100% of the IFN-beta plus TX 527-treated mice had normal blood glucose levels during treatment, and even had a more pronounced prolongation of graft survival (MST 62 days, P < 0.005 versus controls). Cytokine mRNA analysis of the grafts 6 days after transplantation revealed a significant decrease in IL-2, IFN-gamma and IL-12 messages in both IFN-beta plus TX 527- and CsA plus TX 527-treated mice, while only in the IFN-beta with TX 527 group were higher levels of IL-10 transcripts observed. Therefore, we conclude that a combination of IFN-beta and TX 527 delays autoimmune diabetes recurrence in islet grafts in spontaneously diabetic NOD mice.
自身免疫性糖尿病复发在一定程度上导致了1型糖尿病患者胰岛移植移植物的破坏。本研究的目的是设计能够预防自发糖尿病NOD小鼠胰岛移植后自身免疫性糖尿病复发的治疗方法。为了避免自身免疫性糖尿病复发与同种异体移植排斥反应之间的混淆,我们在自发糖尿病NOD小鼠中进行了同基因胰岛移植。小鼠分别接受小鼠干扰素-β(IFN-β,1×105 IU/天)、一种新的14-表-1,25-二羟基维生素D3类似物(TX 527,5μg/kg/天)和环孢素A(CsA,7.5 mg/kg/天)单一用药及联合用药治疗。移植后20天(IFN-β和CsA组)或30天(TX 527组)停止治疗。100%的对照小鼠出现自身免疫性糖尿病复发(中位生存时间11天)。单一疗法均未显著延长胰岛移植移植物的存活时间。CsA与TX 527联合用药时,只要持续给药,67%的受体小鼠的移植物功能得以维持(中位生存时间31天,与对照组相比P<0.01)。有趣的是,100%接受IFN-β加TX 527治疗的小鼠在治疗期间血糖水平正常,甚至移植物存活时间延长更显著(中位生存时间62天,与对照组相比P<0.005)。移植后6天对移植物进行细胞因子mRNA分析显示,接受IFN-β加TX 527和CsA加TX 527治疗小鼠的IL-2、IFN-γ和IL-12信息显著减少,而仅在IFN-β与TX 527组观察到IL-10转录本水平较高。因此,我们得出结论,IFN-β与TX 527联合用药可延缓自发糖尿病NOD小鼠胰岛移植中自身免疫性糖尿病的复发。