Transplante de ilhotas na prática clínica: estado atual e perspectivas

Eliaschewitz, Freddy Goldberg; Franco, Denise Reis; Mares-Guia, Thiago Rennó dos; Noronha, Irene L.; Labriola, Letícia; Sogayar, Mari Cleide

doi:10.1590/s0004-27302009000100004

Cited by 7 publications

(6 citation statements)

References 59 publications

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“…Great successes have been achieved with this treatment plan [8–11]. However, there are still several hurdles before the real success [12]. The first major hurdle is the source and choice of more qualified grafts which directly affect the short-term effectivity and long-term survival of the transplanted islets [4].…”

Section: Introductionmentioning

confidence: 99%

Small Islets Transplantation Superiority to Large Ones: Implications from Islet Microcirculation and Revascularization

Zhao

Liu

et al. 2014

Journal of Diabetes Research

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Pancreatic islet transplantation is a promising therapy to regain glycemic control in diabetic patients. The selection of ideal grafts is the basis to guarantee short-term effectivity and longevity of the transplanted islets. Contradictory to the traditional notion, recent findings implied the superiority of small islets for better transplantation outcomes rather than the large and intact ones. However, the mechanisms remain to be elucidated. Recent evidences emphasized the major impact of microcirculation on islet β-cell mass and function. And potentials in islet graft revascularization are crucial for their survival and preserved function in the recipient. In this study, we verified the distinct histological phenotype and functionality of small islets versus large ones both in vitro and in vivo. With efforts to exploring the differences in microcirculation and revascularization of islet grafts, we further evaluated local expressions of angiotensin and vascular endothelial growth factor A (VEGF-A) at different levels. Our findings reveal that, apart from the higher density of insulin-producing β-cells, small islets express less angiotensin and more angiotrophic VEGF-A. We therefore hypothesized a logical explanation of the small islet superiority for transplantation outcome from the aspects of facilitated microcirculation and revascularization intrinsically in small islets.

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Section: Introductionmentioning

confidence: 99%

Small Islets Transplantation Superiority to Large Ones: Implications from Islet Microcirculation and Revascularization

Zhao

Liu

et al. 2014

Journal of Diabetes Research

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“…One of the most important restrictions hampering the technical development of islet transplantation consists of the autoimmune response and rejection after transplantation which must still be overcome. It is essential, therefore, to develop an unlimited source of cells capable of secreting insulin in response to glucose and able to be transplanted with little or no need for systemic immunosuppression 6,7 .…”

Section: B Introductionmentioning

confidence: 99%

Parameters involved and viability of immunosuppression on islet allotransplantation procedure in rodents

Iuamoto¹,

Meyer²,

Chaib³

et al. 2014

Medical Express

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INTRODUCTION: Autoimmunity and rejection after transplantation must still be overcome in the technical development of islet transplantation for the treatment of type 1 diabetes. It is therefore necessary to inhibit rejection of islet grafts while maintaining the graft's ability to secrete insulin. Although the use of immunosuppressants reduces the acute rejection rate in transplant patients, long-term side effects must be prevented. OBJECTIVES: The aim of the present study is to organize and analyze the parameters of immunosuppression involved in experimental attempts of allotransplantation in rodents. METHODOLOGY: This review was performed using the Pubmed database to search for published articles containing the keywords "rodent islet transplantation". The inclusion criteria involved allotransplantation with rodents' islets and the reference lists of the publications retrieved that were eligible. The exclusion criteria involved isotransplantation, autotransplantation, and xenotransplantation such as transplantation in other species. RESULTS: Twenty studies related to allotransplantation were selected for this systematic review based on immunosuppression. CONCLUSION: New immunosuppressive drugs increased the survival rates of allotransplantation in rodents by reducing the side effects. The advances in immunosuppression raise the possibility of overcoming autoimmunity and rejection after allotransplantation.

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“…Algumas restrições foram encontradas no avanço das técnicas do transplante de ilhotas: o fato de o número de doadores de pâncreas para o transplante de ilhotas estar aquém do necessário para a cura de milhões de indivíduos portadores de diabetes tipo 1; as dificuldades técnicas e o custo do isolamento das ilhotas; pouca durabilidade da insulinoindependência; além da autoimunidade e a rejeição pós-transplante que ainda devem ser superadas. É fundamental, portanto, que se desenvolva uma fonte ilimitada de células capazes de secretar insulina em resposta à glicose e passíveis de serem transplantadas com pouca ou sem a necessidade de imunossupressão sistêmica 6 . A técnica de transplante de ilhotas vem sendo desenvolvida para se adquirir uma fonte adequada de insulina no transplantado, solucionando o problema da escassez de doadores.…”

Section: Introductionunclassified

Revisão sistemática sobre alotransplantes de ilhotas de Langerhans em roedores: análise de sítio de transplante e tempo de sobrevida

Iuamoto

Meyer

Chaib

et al. 2014

Rev. Med. (São Paulo)

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Iuamoto LR, Meyer A, Chaib E, D'Albuquerque LAC. Revisão sistemática sobre alotransplantes de ilhotas de Langerhans em roedores: análise de sítio de transplante e tempo de sobrevida / Systematic review of islet allotransplantation in rodents: analysis of transplantation site and survival time. Rev Med (São Paulo). 2014 out.-dez.;93(4):151-8. RESUMO:Introdução. A escassez de ilhotas é uma restrição importante ao uso de ilhotas pancreáticas para o desenvolvimento do alotransplante para o tratamento do diabetes tipo I. É necessário, portanto, desenvolver fonte ilimitada de células produtoras de insulina. Objetivos. Organizar e analisar dados sobre o sítio de transplante e o tempo de sobrevida relacionados a tentativas experimentais de alotransplante em roedores, a fim de permitir elaborar um modelo mais adequado para suprir a escassez de doadores de ilhotas. Metodologia. Realizamos uma revisão sistemática usando o banco de dados Pubmed para pesquisar artigos publicados que contenham as palavraschaves "rodent islet transplantation". Foram incluídos estudos envolvendo experimentos alotransplante de ilhotas de roedores e analisadas as listas de referências das publicações recuperadas. Artigos relacionados a isotransplantes, autotransplantes e xenotransplantes foram excluídos do estudo. Resultados. Um total de 30 estudos relacionados a alotransplantes em diferentes sítios de enxerto foram selecionados para a revisão sistemática baseados na relevância de seus dados e em sua atualização. O fígado e a cápsula renal são sítios que possibilitaram uma maior sobrevida das ilhotas transplantadas. Conclusão. O alotransplante em roedores é promissor e continua a se desenvolver em diversos centros. As taxas de sobrevivência de aloenxertos aumentaram com a utilização de diferentes medicamentos e locais de enxerto. DESCRITORES: Transplante de ilhotas pancreáticas;Hiperglicemia; Modelo animal; Aloenxertos; Imunossupressão; Literatura de revisão como assunto. ABSTRACT: Introduction. The scarcity of islets is an important use of pancreatic islets for the development of allograft for the treatment of diabetes type I. It is therefore necessary to develop unlimited source of insulin-producing cells restriction.Objectives. Organize and analyze parameters related to the site of transplantation and survival time related to experimental rodent allotransplantation attempts in order to allow the elaboration of the most suitable model to supply the scarcity of islet donors. Methodology. We performed a systematic review using the PubMed database to search published articles containing the keywords "rodent islet transplantation". We included studies involving allotransplantation experiments with rodents' islets and we reviewed the reference lists of the publications retrieved that were eligible. We excluded articles related to isotransplantation, autotransplantation and xenotransplantation such as transplantation in other species. Articles related to isotransplantations, transplantations and xenografts were excluded from the study. Results. A tot...

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Transplante de ilhotas na prática clínica: estado atual e perspectivas

Cited by 7 publications

References 59 publications

Small Islets Transplantation Superiority to Large Ones: Implications from Islet Microcirculation and Revascularization

Small Islets Transplantation Superiority to Large Ones: Implications from Islet Microcirculation and Revascularization

Parameters involved and viability of immunosuppression on islet allotransplantation procedure in rodents

Revisão sistemática sobre alotransplantes de ilhotas de Langerhans em roedores: análise de sítio de transplante e tempo de sobrevida

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