Malinowski Maciej, Pratschke Johann, Lock Johan, Neuhaus Peter, Stockmann Martin
Department of General, Visceral, and Transplantation Surgery, University Hospital Charité, Berlin, Germany.
Ann Transplant. 2010 Jul-Sep;15(3):60-5.
BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a serious complication after transplantation. The complex clinical situation makes it difficult to distinct influence of the single factors. To define impact of calcineurin inhibitor therapy on the PTDM after transplantation an experimental study analyzing the impact of different tacrolimus - dosages on the pancreatic beta-cell function was designed. MATERIAL/METHODS: Male Wistar rats received different doses of tacrolimus (0.1, 0.5, 1 and 10 mg/kg day) or tap water for 14 days. Serum glucose, insulin and creatinine levels were measured. Pancreas tissue was fixed in formaldehyde and stained with anti-insulin antibody. Staining intensity was assessed in a semiquantitive, blinded manner. RESULTS: There was no difference in the serum glucose and insulin levels between the tacrolimus treated and the control group. In the 10 mg/kg group the insulin amount in pancreas beta cells was significantly decreased, while the serum creatinine concentration was significantly increased. All other dosages showed no significant influence on function of insulin producing cells. CONCLUSIONS: Tacrolimus in therapeutic dosages has no influence on the pancreas insulin production after 14 days of treatment. In contrast toxic tacrolimus dosages has a decreasing effect on insulin production, but is not associated with hypoinsulinemia. Only high doses of tacrolimus might induce glucose intolerance in transplanted patients.
背景:移植后糖尿病(PTDM)是移植后的一种严重并发症。复杂的临床情况使得难以明确单一因素的影响。为了确定钙调神经磷酸酶抑制剂治疗对移植后PTDM的影响,设计了一项实验研究,分析不同剂量他克莫司对胰腺β细胞功能的影响。 材料/方法:雄性Wistar大鼠接受不同剂量的他克莫司(0.1、0.5、1和10mg/kg/天)或自来水,持续14天。测量血清葡萄糖、胰岛素和肌酐水平。胰腺组织用甲醛固定,并用抗胰岛素抗体染色。以半定量、盲法评估染色强度。 结果:他克莫司治疗组和对照组的血清葡萄糖和胰岛素水平无差异。在10mg/kg组中,胰腺β细胞中的胰岛素量显著减少,而血清肌酐浓度显著增加。所有其他剂量对胰岛素产生细胞的功能均无显著影响。 结论:治疗剂量的他克莫司在治疗14天后对胰腺胰岛素分泌无影响。相比之下,他克莫司的毒性剂量对胰岛素分泌有降低作用,但与低胰岛素血症无关。只有高剂量的他克莫司可能会导致移植患者出现葡萄糖不耐受。
Ann Transplant. 2010
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