Li H, Kaufman C L, Ildstad S T
Department of Surgery, University of Pittsburgh, PA 15261, USA.
Surgery. 1995 Aug;118(2):192-7; discussion 197-8. doi: 10.1016/s0039-6060(05)80323-x.
Nonobese diabetic (NOD) mice develop a systemic autoimmune disease that resembles type I diabetes in human beings. Previous studies in NOD mice have shown that transplantation of bone marrow from normal donors to lethally conditioned recipients prevented the development of diabetes (B10.BR-->NOD, BALB/c-->NOD). The focus of the present study was to examine whether donor-specific transplantation tolerance for islet allografts could be achieved if islet transplantations were performed coincident with the time of bone marrow infusion in diabetic NOD mice. Moreover, the transplanted islets were evaluated for evidence of recurrent autoimmunity.
Female NOD mice were followed until autoimmune diabetes occurred (urine glucose, to +; blood glucose level, 300 mg/dl or greater). Diabetic NOD mice were irradiated with 950 cGy total body irradiation and received 30 x 10(6) untreated B10.BR bone marrow cells (B10.BR-->NOD). A simultaneous islet allograft was placed under the renal capsule within 24 hours after infusion of the bone marrow cells. Mice were monitored by means of blood glucose levels, and histologic analyses were performed on the transplanted islet.
Islet allografts genetically matched to the bone marrow donor were significantly prolonged (n = 5; mean survival time, 206 days or more) and showed no evidence for chronic rejection or recurrent insulitis, whereas major histocompatibility complex-disparate third-party allografts were rejected (n = 3; mean survival time, 37 days) and exhibited lymphocytic infiltration compatible with rejection on histologic evaluation.
These data suggest that permanent donor-specific tolerance to islet allografts placed simultaneously with bone marrow transplantation can be achieved in diabetic NOD mice. Moreover, recurrent autoimmune destruction of the pancreatic tissue is prevented by the bone marrow chimerism.
非肥胖糖尿病(NOD)小鼠会发展出一种类似于人类 I 型糖尿病的全身性自身免疫性疾病。先前对 NOD 小鼠的研究表明,将正常供体的骨髓移植到经过致死剂量预处理的受体中可预防糖尿病的发生(B10.BR→NOD,BALB/c→NOD)。本研究的重点是检查在糖尿病 NOD 小鼠中,若在输注骨髓时同时进行胰岛移植,是否能实现对胰岛同种异体移植的供体特异性移植耐受。此外,对移植的胰岛进行评估,以寻找复发性自身免疫的证据。
对雌性 NOD 小鼠进行跟踪观察,直至出现自身免疫性糖尿病(尿糖呈阳性;血糖水平达到 300mg/dl 或更高)。对糖尿病 NOD 小鼠进行 950cGy 的全身照射,并接受 30×10⁶ 个未经处理的 B10.BR 骨髓细胞(B10.BR→NOD)。在输注骨髓细胞后 24 小时内,将同时进行的胰岛同种异体移植置于肾被膜下。通过血糖水平对小鼠进行监测,并对移植的胰岛进行组织学分析。
与骨髓供体基因匹配的胰岛同种异体移植存活时间显著延长(n = 5;平均存活时间为 206 天或更长),且未显示出慢性排斥或复发性胰岛炎的证据,而主要组织相容性复合体不匹配的第三方同种异体移植被排斥(n = 3;平均存活时间为 37 天),并且在组织学评估中表现出与排斥相符的淋巴细胞浸润。
这些数据表明,在糖尿病 NOD 小鼠中,可实现与骨髓移植同时进行的胰岛同种异体移植的永久性供体特异性耐受。此外,骨髓嵌合可防止胰腺组织的复发性自身免疫性破坏。