Qi Meirigeng, Omori Keiko, Mullen Yoko, McFadden Brian, Valiente Luis, Juan Jemily, Bilbao Shiela, Tegtmeier Bernard R, Dafoe Donald, Kandeel Fouad, Al-Abdullah Ismail H
Department of Translational Research and Cellular Therapeutics, Diabetes and Metabolism Research Institute, Beckman Research Institute of City of Hope.
Division of Clinical Pathology, Department of Pathology of City of Hope.
Transplant Direct. 2016 Feb;2(2):e63. doi: 10.1097/TXD.0000000000000574.
Transplanting pancreatic islets into recipients must be safe and effective to treat Type 1 diabetes. Islet quality and quantity are important, however, the final product must also be free from microbial contamination and low endotoxin levels.
This study explored a method to eliminate contamination in manufacturing islets for transplantation. A simple (single antibiotic, n=164) and refined (triple antimicrobial agents, n=279) pancreas decontaminating methods were used to test their effects on reducing the contamination rates in the islet final product. A total of 443 pancreata were processed for islet isolations. Three samples for microbial tests (Gram stain, aerobic, and anaerobic culture) were taken at pre-process (pancreas preservation), post-isolation, and post-culture. Endotoxin levels were measured only for islets considered for transplantation.
Out of 443 pancreata used for islet isolation, 79 (17.8%) showed signs of contamination in pre-process samples; 10 (2.3%) were contaminated in both pre-process and in the final product (post-isolation and post-culture) samples. Contamination rates in which pre-process and final product samples were positive for contamination was significantly lower using the refined method (refined vs. simple method: 5% vs. 20.5%, p=0.045). Identical microbial species were present in both pre-process and in the final product.
This study demonstrated that the refined method reduces the rate of contamination of the islet final product and is safe for clinical application. Moreover, it may be used as a standard method during human islet manufacturing facilitating the application of a biological license agreement from United States Food and Drug Administration.
将胰岛移植到受体体内治疗1型糖尿病必须安全有效。胰岛的质量和数量很重要,然而,最终产品也必须无微生物污染且内毒素水平低。
本研究探索了一种消除移植用胰岛制造过程中污染的方法。采用一种简单的(单一抗生素,n = 164)和改良的(三种抗菌剂,n = 279)胰腺去污方法来测试它们对降低胰岛最终产品污染率的效果。总共443个胰腺被用于胰岛分离。在预处理(胰腺保存)、分离后和培养后采集三个样本进行微生物检测(革兰氏染色、需氧和厌氧培养)。仅对考虑用于移植的胰岛测量内毒素水平。
在用于胰岛分离的443个胰腺中,79个(17.8%)在预处理样本中显示污染迹象;10个(2.3%)在预处理和最终产品(分离后和培养后)样本中均被污染。使用改良方法时,预处理和最终产品样本污染呈阳性的污染率显著更低(改良方法与简单方法:5%对20.5%,p = 0.045)。预处理和最终产品中存在相同的微生物种类。
本研究表明改良方法降低了胰岛最终产品的污染率,且临床应用安全。此外,它可作为人类胰岛制造过程中的标准方法,有助于获得美国食品药品监督管理局的生物许可协议。