Exosomes are known for their ability to transport nucleic acid, lipid, and protein molecules, which allows for communication between cells and tissues. The cargo of the exosomes can have a variety of effects on a wide range of targets to mediate biological function. Pancreatic islet transplantation is a minimally invasive cell replacement therapy to prevent or reverse diabetes mellitus and is currently performed in patients with uncontrolled type 1 diabetes or chronic pancreatitis. Exosomes have become a focus in the field of islet transplantation for the study of diagnostic markers of islet cell viability and function. A growing list of miRNAs identified from exosomes collected during the process of isolating islets can be used as diagnostic biomarkers of islet stress and damage, leading to a better understanding of critical steps of the isolation procedure that can be improved to increase islet yield and quality. Exosomes have also been implicated as a possible contributor to islet graft rejection following transplantation, as they carry donor major histocompatibility complex molecules, which are then processed by recipient antigen-presenting cells and sensed by the recipient immune cells. Exosomes may find their way into the therapeutic realm of islet transplantation, as exosomes isolated from mesenchymal stem cells have shown promising results in early studies that have seen increased viability and functionality of isolated and grafted islets in vitro as well as in vivo. With the study of exosomes still in its infancy, continued research on the role of exosomes in islet transplantation will be paramount to understanding beta cell regeneration and improving long-term graft function.
Conclusion:Recipients of islets from at least one female donor exhibited prolonged graft survival compared to recipients of islets from exclusively male donors. In addition, female recipients exhibited prolonged survival compared to male recipients following ITx of at least one female donor.
Pancreatic beta cells undergoing metabolic and inflammatory stress express islet-derived cytokines or “isletokines” which can induce immune cell infiltration and cellular damage leading to loss of islet cell function. We and others have shown that toll-like receptor (TLR) 4 in islets can mediate metabolic and inflammatory response to DAMPs under diabetic conditions and in islet cell transplantation. Here we show that metabolic and inflammatory conditions result in induction and suppression of expression of multiple members of the TLR family in both MIN6 beta-cell line and mouse islets. Among upregulated TLRs, the endosomal nucleic acid-sensing TLR3 was most highly induced (up to 5 fold) in response to cytokine cocktail IL-1beta, TNF-alpha, and IFN-gamma in the presence of high glucose. Induction of TLR3 expression was blocked by PI3 kinase inhibitor wortmannin and unaffected by mTOR inhibitor rampamycin, calcineurin inhibitor FK506, and NF-κB inhibitor BMS345541. Immunoblot analyses confirmed that TLR3 but not TLR4 protein expression was wortmannin sensitive. These data indicate that TLR3 is upregulated by PI3 kinase signaling in islet beta cells in response to inflammatory conditions. As the endosomal TLR3 signaling is known to sense nucleic acids as well as influence glucose homeostasis, we propose that beta cells may sense DNA damage to induce isletokines to mediate local inflammatory responses during metabolic and inflammatory stress. Further investigations are warranted to decipher signaling pathways and molecular targets of TLR3 signaling to alleviate islet inflammation and improve beta-cell function.
Disclosure
J.D.Mattke: None. B.Naziruddin: None. M.C.Lawrence: None.
Purpose: Loss of islet mass by instant blood mediated inflammatory reaction (IBMIR) and immunological rejection are major hurdles currently facing the field of islet transplantation. Toll-like receptor 4 (TLR4) plays a central role in inflammation and shaping adaptive immune response. We investigated the protective effects of resatorvid (TAK-242) using in vitro models of islet transplantation.
Methods: Soluble TAK-242 or TAK-242 conjugated to the surface of islets utilizing copper-free click chemistry with a cleavable chemical linker were used. Islets were mixed with allogenic blood for a period of 3 hours and plasma levels of miRNA-375 and miRNA-200c were analyzed by RT-qPCR. Allogenic peripheral blood mononuclear cells were cultured with islets. T cell and monocyte activation were monitored by flow cytometry. Cytokine and miRNA levels in culture supernatant were measured by Luminex assay and RT-qPCR respectively.
Results: The presence of TAK-242 in soluble form as well as released by cleavable linker from islet surface significantly reduced the release of miRNA-375 (p<0.01) and miRNA-200c (p<0.01) indicating less islet damage. In allogenic co-culture of islets and PBMCs, TAK-242 inhibited the expression of CD69 in T cells as well as decreased (p<0.05) the expression of CD86 and CD80 in monocytes. The production of cytokines IL-1β (p<0.001), IL-6 (p=0.01), IL-8 (p<0.05), IP10 (p<0.05), MCP-1 (p<0.001) and TNFα (p=0.005) in culture supernatant was decreased in the presence of soluble TAK-242 as well as TAK-242 released from islet surfaces.
Conclusions: Inhibition of TLR4 using small molecule, TAK-242, protected islets from innate damage due to IBMIR as well as adaptive responses of activation of T cells and monocytes. These results validate the future study of inhibition of TLR4 using in vivo transplant model(s) to further investigate the efficacy of TLR4 inhibition to improve islet transplant survival and function.
Disclosure
J.D.Mattke: None. B.Naziruddin: None. B.Kane: None.
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