Paz-Barba Miriam, Peters Iris J A, de Graaf Natascha, Carlotti Françoise, de Koning Eelco J P
Department of Internal Medicine, Leiden University Medical Centre, Leiden, the Netherlands.
Transplant Direct. 2025 May 12;11(6):e1770. doi: 10.1097/TXD.0000000000001770. eCollection 2025 Jun.
Methylprednisolone is a glucocorticoid often used for immunosuppressive induction therapy or treatment of rejection in the context of organ transplantation and preservation of long-term function. In pancreas and islet transplantation, there is more reluctance to use high-dose methylprednisolone when there is suspicion of rejection, partly due to its hyperglycemic effects and doubts about the rescue of islet function. Here we investigated the functional and molecular effects of high-dose methylprednisolone on human pancreatic beta cells in an inflammatory environment, focusing on the nuclear factor kappa B and endoplasmic reticulum stress pathways.
We exposed primary human islets or human beta cells to proinflammatory cytokines in the presence or absence of methylprednisolone for 3 d and characterized its effects on beta-cell death, function, gene and protein expression, and secretion of inflammatory molecules.
Methylprednisolone prevented cytokine-induced beta-cell failure and death (57% decrease in caspase 3/7 activation [ < 0.05]) after 72 h. This protective effect was associated with an 80% attenuation of the inflammatory cytokine gene (80%, < 0.01), the proapoptotic nuclear factor kappa B-related gene (26%, < 0.05), and endoplasmic reticulum stress gene (48%, < 0.05) during cytokine treatment.
We propose that short-term treatment with methylprednisolone is beneficial for beta-cell health under inflammatory conditions which can be relevant in periprocedural pancreas or islet transplantation, and treatment of graft rejection.
甲泼尼龙是一种糖皮质激素,常用于免疫抑制诱导治疗或器官移植中的排斥反应治疗以及长期功能的维持。在胰腺和胰岛移植中,当怀疑有排斥反应时,人们更不愿意使用高剂量甲泼尼龙,部分原因是其高血糖作用以及对胰岛功能挽救效果的怀疑。在此,我们研究了高剂量甲泼尼龙在炎症环境中对人胰腺β细胞的功能和分子影响,重点关注核因子κB和内质网应激途径。
我们将原代人胰岛或人β细胞在有或无甲泼尼龙的情况下暴露于促炎细胞因子中3天,并表征其对β细胞死亡、功能、基因和蛋白质表达以及炎症分子分泌的影响。
72小时后,甲泼尼龙可预防细胞因子诱导的β细胞功能衰竭和死亡(半胱天冬酶3/7激活降低57%[<0.05])。这种保护作用与细胞因子治疗期间炎症细胞因子基因(80%,<0.01)、促凋亡核因子κB相关基因(26%,<0.05)和内质网应激基因(48%,<0.05)的表达衰减80%有关。
我们提出,在围手术期胰腺或胰岛移植以及移植物排斥反应治疗中可能相关的炎症条件下,短期使用甲泼尼龙对β细胞健康有益。