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Smith KE, Kelly AC, Min CG, Weber CS, McCarthy FM, Steyn LV, Badarinarayana V, Stanton JB, Kitzmann JP, Strop P, Gruessner AC, Lynch RM, Limesand SW, Papas KK. Acute Ischemia Induced by High-Density Culture Increases Cytokine Expression and Diminishes the Function and Viability of Highly Purified Human Islets of Langerhans. Transplantation 2017; 101:2705-2712. [PMID: 28263224 PMCID: PMC6319561 DOI: 10.1097/tp.0000000000001714] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/24/2017] [Accepted: 02/16/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Encapsulation devices have the potential to enable cell-based insulin replacement therapies (such as human islet or stem cell-derived β cell transplantation) without immunosuppression. However, reasonably sized encapsulation devices promote ischemia due to high β cell densities creating prohibitively large diffusional distances for nutrients. It is hypothesized that even acute ischemic exposure will compromise the therapeutic potential of cell-based insulin replacement. In this study, the acute effects of high-density ischemia were investigated in human islets to develop a detailed profile of early ischemia induced changes and targets for intervention. METHODS Human islets were exposed in a pairwise model simulating high-density encapsulation to normoxic or ischemic culture for 12 hours, after which viability and function were measured. RNA sequencing was conducted to assess transcriptome-wide changes in gene expression. RESULTS Islet viability after acute ischemic exposure was reduced compared to normoxic culture conditions (P < 0.01). Insulin secretion was also diminished, with ischemic β cells losing their insulin secretory response to stimulatory glucose levels (P < 0.01). RNA sequencing revealed 657 differentially expressed genes following ischemia, with many that are associated with increased inflammatory and hypoxia-response signaling and decreased nutrient transport and metabolism. CONCLUSIONS In order for cell-based insulin replacement to be applied as a treatment for type 1 diabetes, oxygen and nutrient delivery to β cells will need to be maintained. We demonstrate that even brief ischemic exposure such as would be experienced in encapsulation devices damages islet viability and β cell function and leads to increased inflammatory signaling.
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Affiliation(s)
- Kate E. Smith
- Department of Surgery, University of Arizona, Tucson, AZ
- Department of Physiological Sciences GIDP, University of Arizona, Tucson, AZ
| | - Amy C. Kelly
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ
| | - Catherine G. Min
- Department of Surgery, University of Arizona, Tucson, AZ
- Department of Physiological Sciences GIDP, University of Arizona, Tucson, AZ
| | - Craig S. Weber
- Department of Physiology, University of Arizona, Tucson, AZ
| | - Fiona M. McCarthy
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ
| | - Leah V. Steyn
- Department of Surgery, University of Arizona, Tucson, AZ
| | | | | | | | - Peter Strop
- Sanofi-Aventis Group, Tucson, AZ
- Icagen, Inc., Tucson, AZ
| | | | | | - Sean W. Limesand
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ
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Einstein SA, Weegman BP, Kitzmann JP, Papas KK, Garwood M. Noninvasive assessment of tissue-engineered graft viability by oxygen-17 magnetic resonance spectroscopy. Biotechnol Bioeng 2016; 114:1118-1121. [PMID: 27869295 DOI: 10.1002/bit.26227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/27/2016] [Accepted: 11/14/2016] [Indexed: 02/05/2023]
Abstract
Transplantation of macroencapsulated tissue-engineered grafts (TEGs) is being investigated as a treatment for type 1 diabetes, but there is a critical need to measure TEG viability both in vitro and in vivo. Oxygen deficiency is the most critical issue preventing widespread implementation of TEG transplantation and delivery of supplemental oxygen (DSO) has been shown to enhance TEG survival and function in vivo. In this study, we demonstrate the first use of oxygen-17 magnetic resonance spectroscopy (17 O-MRS) to measure the oxygen consumption rate (OCR) of TEGs and show that in addition to providing therapeutic benefits to TEGs, DSO with 17 O2 can also enable measurements of TEG viability. Macroencapsulated TEGs containing βTC3 murine insulinoma cells were prepared with three fractional viabilities and provided with 17 O2 . Cellular metabolism of 17 O2 into nascent mitochondrial water (H217 O) was monitored by 17 O-MRS and, from the measured data, OCR was calculated. For comparison, OCR was simultaneously measured on a separate, but equivalent sample of cells with a well-established stirred microchamber technique. OCR measured by 17 O-MRS agreed well with measurements made in the stirred microchamber device. These studies confirm that 17 O-MRS can quantify TEG viability noninvasively. Biotechnol. Bioeng. 2017;114: 1118-1121. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Samuel A Einstein
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, 2021 Sixth Street SE, Minneapolis, Minnesota, 55455
| | - Bradley P Weegman
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, 2021 Sixth Street SE, Minneapolis, Minnesota, 55455
| | | | | | - Michael Garwood
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, 2021 Sixth Street SE, Minneapolis, Minnesota, 55455
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Weegman BP, Kumar Sajja VS, Suszynski TM, Rizzari MD, Scott III WE, Kitzmann JP, Mueller KR, Hanley TR, Kennedy DJ, Todd PW, Balamurugan AN, Hering BJ, Papas KK. Continuous Quadrupole Magnetic Separation of Islets during Digestion Improves Purified Porcine Islet Viability. J Diabetes Res 2016; 2016:6162970. [PMID: 27843954 PMCID: PMC5097811 DOI: 10.1155/2016/6162970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 06/23/2016] [Accepted: 07/11/2016] [Indexed: 11/17/2022] Open
Abstract
Islet transplantation (ITx) is an emerging and promising therapy for patients with uncontrolled type 1 diabetes. The islet isolation and purification processes require exposure to extended cold ischemia, warm-enzymatic digestion, mechanical agitation, and use of damaging chemicals for density gradient separation (DG), all of which reduce viable islet yield. In this paper, we describe initial proof-of-concept studies exploring quadrupole magnetic separation (QMS) of islets as an alternative to DG to reduce exposure to these harsh conditions. Three porcine pancreata were split into two parts, the splenic lobe (SPL) and the combined connecting/duodenal lobes (CDL), for paired digestions and purifications. Islets in the SPL were preferentially labeled using magnetic microparticles (MMPs) that lodge within the islet microvasculature when infused into the pancreas and were continuously separated from the exocrine tissue by QMS during the collection phase of the digestion process. Unlabeled islets from the CDL were purified by conventional DG. Islets purified by QMS exhibited significantly improved viability (measured by oxygen consumption rate per DNA, p < 0.03) and better morphology relative to control islets. Islet purification by QMS can reduce the detrimental effects of prolonged exposure to toxic enzymes and density gradient solutions and substantially improve islet viability after isolation.
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Affiliation(s)
- Bradley P. Weegman
- CMRR, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
- Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | | | - Thomas M. Suszynski
- Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Michael D. Rizzari
- Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - William E. Scott III
- Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Surgery, University of Arizona, Tucson, AZ, USA
| | | | - Kate R. Mueller
- Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - Thomas R. Hanley
- Department of Chemical Engineering, Auburn University, Auburn, AL, USA
| | | | | | - Appakalai N. Balamurugan
- Clinical Islet Cell Laboratory, Cardiovascular Innovation Institute, Department of Surgery, University of Louisville, Louisville, KY 40202, USA
| | - Bernhard J. Hering
- Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Klearchos K. Papas
- Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Surgery, University of Arizona, Tucson, AZ, USA
- *Klearchos K. Papas:
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Griffin KH, Johnson JR, Kitzmann JP, Kolste AK, Dusek JA. Outcomes of a Multimodal Resilience Training Program in an Outpatient Integrative Medicine Clinic. J Altern Complement Med 2015; 21:628-37. [DOI: 10.1089/acm.2015.0130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kristen H. Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Jill R. Johnson
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Jennifer P. Kitzmann
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Alison K. Kolste
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Jeffery A. Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
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Kitzmann JP, Karatzas T, Mueller KR, Avgoustiniatos ES, Gruessner AC, Balamurugan AN, Bellin MD, Hering BJ, Papas KK. Islet preparation purity is overestimated, and less pure fractions have lower post-culture viability before clinical allotransplantation. Transplant Proc 2015; 46:1953-5. [PMID: 25131080 DOI: 10.1016/j.transproceed.2014.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Replacement of β-cells with the use of isolated islet allotransplantation (IT) is an emerging therapy for type 1 diabetics with hypoglycemia unawareness. The current standard protocol calls for a 36-72-hour culture period before IT. We examined 13 clinical islet preparations with ≥2 purity fractions to determine the effect of culture on viability. METHODS After standard islet isolation and purification, pure islet fractions were placed at 37°C with 5% CO2 for 12-24 hours and subsequently moved to 22°C, whereas less pure fractions were cultured at 22°C for the entire duration. Culture density was targeted at a range of 100-200 islet equivalents (IEQ)/cm(2) adjusted for purity. Islets were assessed for purity (dithizone staining), quantity (pellet volume and DNA), and viability (oxygen consumption rate normalized to DNA content [OCR/DNA] and membrane integrity). RESULTS Results indicated that purity was overestimated, especially in less pure fractions. This was evidenced by significantly larger observed pellet sizes than expected and tissue amount as quantified with the use of a dsDNA assay when available. Less pure fractions showed significantly lower OCR/DNA and membrane integrity compared with pure. The difference in viability between the 2 purity fractions may be due to a variety of reasons, including hypoxia, nutrient deficiency, toxic metabolite accumulation, and/or proteolytic enzymes released by acinar tissue impurities that are not neutralized by human serum albumin in the culture media. CONCLUSIONS Current clinical islet culture protocols should be examined further, especially for less pure fractions, to ensure the maintenance of viability before transplantation. Even though relatively small, the difference in viability is important because the amount of dead or dying tissue introduced into recipients may be dramatically increased, especially with less pure preparations.
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Affiliation(s)
- J P Kitzmann
- Department of Surgery, University of Arizona, Tucson, Arizona; Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
| | - T Karatzas
- Department of Surgery, University of Arizona, Tucson, Arizona; Second Department of Propedeutic Surgery, School of Medicine, University of Athens, Athens, Greece
| | - K R Mueller
- Department of Surgery, University of Arizona, Tucson, Arizona; Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
| | | | - A C Gruessner
- Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota
| | - A N Balamurugan
- Department of Surgery, University of Arizona, Tucson, Arizona
| | - M D Bellin
- Department of Surgery, University of Arizona, Tucson, Arizona
| | - B J Hering
- Department of Surgery, University of Arizona, Tucson, Arizona
| | - K K Papas
- Department of Surgery, University of Arizona, Tucson, Arizona; Schulze Diabetes Institute, University of Minnesota, Minneapolis, Minnesota.
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Papas KK, Bellin MD, Sutherland DER, Suszynski TM, Kitzmann JP, Avgoustiniatos ES, Gruessner AC, Mueller KR, Beilman GJ, Balamurugan AN, Loganathan G, Colton CK, Koulmanda M, Weir GC, Wilhelm JJ, Qian D, Niland JC, Hering BJ. Islet Oxygen Consumption Rate (OCR) Dose Predicts Insulin Independence in Clinical Islet Autotransplantation. PLoS One 2015; 10:e0134428. [PMID: 26258815 PMCID: PMC4530873 DOI: 10.1371/journal.pone.0134428] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/10/2015] [Indexed: 12/05/2022] Open
Abstract
Background Reliable in vitro islet quality assessment assays that can be performed routinely, prospectively, and are able to predict clinical transplant outcomes are needed. In this paper we present data on the utility of an assay based on cellular oxygen consumption rate (OCR) in predicting clinical islet autotransplant (IAT) insulin independence (II). IAT is an attractive model for evaluating characterization assays regarding their utility in predicting II due to an absence of confounding factors such as immune rejection and immunosuppressant toxicity. Methods Membrane integrity staining (FDA/PI), OCR normalized to DNA (OCR/DNA), islet equivalent (IE) and OCR (viable IE) normalized to recipient body weight (IE dose and OCR dose), and OCR/DNA normalized to islet size index (ISI) were used to characterize autoislet preparations (n = 35). Correlation between pre-IAT islet product characteristics and II was determined using receiver operating characteristic analysis. Results Preparations that resulted in II had significantly higher OCR dose and IE dose (p<0.001). These islet characterization methods were highly correlated with II at 6–12 months post-IAT (area-under-the-curve (AUC) = 0.94 for IE dose and 0.96 for OCR dose). FDA/PI (AUC = 0.49) and OCR/DNA (AUC = 0.58) did not correlate with II. OCR/DNA/ISI may have some utility in predicting outcome (AUC = 0.72). Conclusions Commonly used assays to determine whether a clinical islet preparation is of high quality prior to transplantation are greatly lacking in sensitivity and specificity. While IE dose is highly predictive, it does not take into account islet cell quality. OCR dose, which takes into consideration both islet cell quality and quantity, may enable a more accurate and prospective evaluation of clinical islet preparations.
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Affiliation(s)
- Klearchos K. Papas
- Institute for Cellular Transplantation, Department of Surgery, University of Arizona, Tucson, Arizona, United States of America
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Melena D. Bellin
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - David E. R. Sutherland
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Thomas M. Suszynski
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Jennifer P. Kitzmann
- Institute for Cellular Transplantation, Department of Surgery, University of Arizona, Tucson, Arizona, United States of America
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Efstathios S. Avgoustiniatos
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Angelika C. Gruessner
- Institute for Cellular Transplantation, Department of Surgery, University of Arizona, Tucson, Arizona, United States of America
| | - Kathryn R. Mueller
- Institute for Cellular Transplantation, Department of Surgery, University of Arizona, Tucson, Arizona, United States of America
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Gregory J. Beilman
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Appakalai N. Balamurugan
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Gopalakrishnan Loganathan
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Clark K. Colton
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Maria Koulmanda
- The Transplant Institute, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gordon C. Weir
- Joslin Diabetes Center, Boston, Massachusetts, United States of America
| | - Josh J. Wilhelm
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
| | - Dajun Qian
- Information Science, City of Hope, Duarte, California, United States of America
| | - Joyce C. Niland
- Information Science, City of Hope, Duarte, California, United States of America
| | - Bernhard J. Hering
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- Schulze Diabetes Institute, Minneapolis, Minnesota, United States of America
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Kitzmann JP, Pepper AR, Lopez BG, Pawlick R, Kin T, O’Gorman D, Mueller KR, Gruessner AC, Avgoustiniatos ES, Karatzas T, Szot GL, Posselt AM, Stock PG, Wilson JR, Shapiro AM, Papas KK. Human islet viability and function is maintained during high-density shipment in silicone rubber membrane vessels. Transplant Proc 2014; 46:1989-91. [PMID: 25131090 PMCID: PMC4169700 DOI: 10.1016/j.transproceed.2014.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The shipment of human islets (IE) from processing centers to distant laboratories is beneficial for both research and clinical applications. The maintenance of islet viability and function in transit is critically important. Gas-permeable silicone rubber membrane (SRM) vessels reduce the risk of hypoxia-induced death or dysfunction during high-density islet culture or shipment. SRM vessels may offer additional advantages: they are cost-effective (fewer flasks, less labor needed), safer (lower contamination risk), and simpler (culture vessel can also be used for shipment). METHOD IE were isolated from two manufacturing centers and shipped in 10-cm(2) surface area SRM vessels in temperature- and pressure-controlled containers to a distant center after at least 2 days of culture (n = 6). Three conditions were examined: low density (LD), high density (HD), and a microcentrifuge tube negative control (NC). LD was designed to mimic the standard culture density for IE preparations (200 IE/cm(2)), while HD was designed to have a 20-fold higher tissue density, which would enable the culture of an entire human isolation in 1-3 vessels. Upon receipt, islets were assessed for viability (measured by oxygen consumption rate normalized to DNA content [OCR/DNA)]), quantity (measured by DNA), and, when possible, potency and function (measured by dynamic glucose-stimulated insulin secretion measurements and transplants in immunodeficient B6 Rag(+/-) mice). Postshipment OCR/DNA was not reduced in HD vs LD and was substantially reduced in the NC condition. HD islets exhibited normal function postshipment. Based on the data, we conclude that entire islet isolations (up to 400,000 IE) may be shipped using a single, larger SRM vessel with no negative effect on viability and ex vivo and in vivo function.
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Affiliation(s)
| | - Andrew R Pepper
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - Boris G Lopez
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - Rena Pawlick
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - Tatsuya Kin
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - Doug O’Gorman
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - Kathryn R Mueller
- Department of Surgery, University of Arizona, Tucson, AZ, United States
| | | | | | - Theodore Karatzas
- Department of Surgery, University of Arizona, Tucson, AZ, United States
- Second Department of Propedeutic Surgery University of Athens, School of Medicine, Athens, Greece
| | - Greg L Szot
- Diabetes Center, University of California, San Francisco, California, United States
| | - Andrew M Posselt
- Diabetes Center, University of California, San Francisco, California, United States
| | - Peter G Stock
- Diabetes Center, University of California, San Francisco, California, United States
| | - John R Wilson
- Wilson Wolf Manufacturing Corporation, New Brighton, Minnesota, United States
| | - AM Shapiro
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - Klearchos K Papas
- Department of Surgery, University of Arizona, Tucson, AZ, United States
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Kitzmann JP, O’Gorman D, Kin T, Gruessner AC, Senior P, Imes S, Gruessner RW, Shapiro AMJ, Papas KK. Islet oxygen consumption rate dose predicts insulin independence for first clinical islet allotransplants. Transplant Proc 2014; 46:1985-8. [PMID: 25131089 PMCID: PMC4170186 DOI: 10.1016/j.transproceed.2014.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Human islet allotransplantation for the treatment of type 1 diabetes is in phase III clinical trials in the U.S. and is the standard of care in several other countries. Current islet product release criteria include viability based on cell membrane integrity stains, glucose-stimulated insulin release, and islet equivalent (IE) dose based on counts. However, only a fraction of patients transplanted with islets that meet or exceed these release criteria become insulin independent following 1 transplant. Measurements of islet oxygen consumption rate (OCR) have been reported as highly predictive of transplant outcome in many models. METHOD In this article we report on the assessment of clinical islet allograft preparations using OCR dose (or viable IE dose) and current product release assays in a series of 13 first transplant recipients. The predictive capability of each assay was examined and successful graft function was defined as 100% insulin independence within 45 days post-transplant. RESULTS OCR dose was most predictive of CTO. IE dose was also highly predictive, while glucoses stimulated insulin release and membrane integrity stains were not. CONCLUSION OCR dose can predict CTO with high specificity and sensitivity and is a useful tool for evaluating islet preparations prior to clinical human islet allotransplantation.
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Affiliation(s)
- JP Kitzmann
- Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - D O’Gorman
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - T Kin
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - AC Gruessner
- Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - P Senior
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - S Imes
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - RW Gruessner
- Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - AMJ Shapiro
- Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
| | - KK Papas
- Department of Surgery, University of Arizona, Tucson, AZ, United States
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Mueller KR, Balamurugan AN, Cline GW, Pongratz RL, Hooper RL, Weegman BP, Kitzmann JP, Taylor MJ, Graham ML, Schuurman HJ, Papas KK. Differences in glucose-stimulated insulin secretion in vitro of islets from human, nonhuman primate, and porcine origin. Xenotransplantation 2013; 20:75-81. [PMID: 23384163 DOI: 10.1111/xen.12022] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 12/28/2012] [Indexed: 01/15/2023]
Abstract
Porcine islet xenotransplantation is considered a potential cell-based therapy for type 1 diabetes. It is currently being evaluated in diabetic nonhuman primates (NHP) to assess safety and efficacy of the islet product. However, due to a variety of distinct differences between the respective species, including the insulin secretory characteristics of islets, the suitability and predictive value of the preclinical model in the extrapolation to the clinical setting remain a critical issue. Islets isolated from human (n = 3), NHP (n = 2), adult pig (AP, n = 3), and juvenile pig (JP, n = 4) pancreata were perifused with medium at basal glucose (2.5 mm) followed by high glucose (16.7 mm) concentrations. The total glucose-stimulated insulin secretion (GSIS) was calculated from generated insulin secretion profiles. Nonhuman primate islets exhibited GSIS 3-fold higher than AP islets, while AP and JP islets exhibited GSIS 1/3 and 1/30 of human islets, respectively. The insulin content of NHP and AP islets was similar to that of human islets, whereas that of JP islets was 1/5 of human islets. Despite the fact that human, NHP, and AP islets contain similar amounts of insulin, the much higher GSIS for NHP islets than for AP and JP islets suggests the need for increased dosing of islets from JP and AP in pig-to-NHP transplantation. Porcine islet xenotransplantation to humans may require significantly higher dosing given the lower GSIS of AP islets compared to human islets.
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Affiliation(s)
- Kate R Mueller
- Department of Surgery, Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN, USA
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Kitzmann JP, Law L, Shome A, Muzina M, Elliott RB, Mueller KR, Schuurman HJ, Papas KK. Real-time assessment of encapsulated neonatal porcine islets prior to clinical xenotransplantation. Xenotransplantation 2012; 19:333-6. [DOI: 10.1111/xen.12005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Suszynski TM, Rizzari MD, Kidder LS, Mueller K, Chapman CS, Kitzmann JP, Pongratz RL, Cline GW, Todd PW, Kennedy DJ, O'Brien TD, Avgoustiniatos ES, Schuurman HJ, Papas KK. Paramagnetic microparticles do not elicit islet cytotoxicity with co-culture or host immune reactivity after implantation. Xenotransplantation 2012; 18:239-44. [PMID: 21848541 DOI: 10.1111/j.1399-3089.2011.00648.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Paramagnetic microparticles (MPs) may be useful in pancreatic islet purification, in particular purification of porcine islets as a potential xenotransplantation product. We assessed whether MPs affect islet function or induce an adverse effect following implantation. METHODS Porcine islets were co-cultured with 0, 500, and 1500 MPs per islet equivalent (IE) for 1 day and with 0 and 1500 MPs/IE for 7 days. Fractional viability was assessed using oxygen consumption rate normalized to DNA content (OCR/DNA) and after 7-day co-culture by perifusion glucose-stimulated insulin secretion (GSIS) and by transplantation under the renal capsule of diabetic nude mice. To assess an inflammatory response or immune reaction, MPs (∼10(7)) were implanted under the renal capsule of C57BL/6 mice. RESULTS No statistically significant differences were measured in OCR/DNA (mean ± SE) following 1-day co-culture with 0, 500, or 1500 MPs/IE (243.3 ± 4.5, 211.3 ± 8.1, or 230.6 ± 11.3 nmol/min·mgDNA, respectively) or following 7-day co-culture with 0 or 1500 MPs/IE (248.5 ± 1.4 or 252.9 ± 4.7 nmol/min·mgDNA, respectively). GSIS was not affected by the presence of MPs; first- and second-phase insulin area-under-the-curve (mean ± SE) reflected no statistically significant differences after 7-day co-culture between 0 and 1500 MPs/IE (8.36 ± 0.29 and 8.45 ± 0.70 pg/ml·min·ngDNA for first-phase; 69.73 ± 2.18 and 65.70 ± 4.34 pg/ml·min·ngDNA for second-phase, respectively). Islets co-cultured with MPs normalized hyperglycemia in diabetic nude mice, suggesting no adverse effects on in vivo islet function. Implantation of MPs did not elicit tissue injury, inflammatory change or immune reactivity. CONCLUSION MPs do not adversely affect islet viability or function during co-culture, and MPs are not immune reactive following implantation.
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Affiliation(s)
- Thomas M Suszynski
- Department of Surgery, Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN 55401, USA
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