| Autor: |
Roep, Bart O., Stobbe, Inge, Duinkerken, Gaby, van Rood, Jon J., Lernmark, Ake, Keymeulen, Bart, Pipeleers, Danny, Claas, Frans H.J., de Vries, Rene R.P., Roep, B O, Stobbe, I, Duinkerken, G, van Rood, J J, Lernmark, A, Keymeulen, B, Pipeleers, D, Claas, F H, de Vries, R R |
| Předmět: |
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| Zdroj: |
Diabetes; Mar1999, Vol. 48 Issue 3, p484-490, 7p, 2 Charts, 3 Graphs |
| Abstrakt: |
Allogeneic islet transplantation can restore an insulin-independent state in C-peptide-negative type 1 diabetic patients. We recently reported three cases of surviving islet allografts that were implanted in type 1 diabetic patients under maintenance immune suppression for a previous kidney graft. The present study compares islet graft-specific cellular auto- and alloreactivity in peripheral blood from those three recipients and from four patients with failing islet allografts measured over a period of 6 months after portal islet implantation. The three cases that remained C-peptide-positive for >1 year exhibited no signs of alloreactivity, and their autoreactivity to islet autoantigens was only marginally increased. In contrast, rapid failure (<3 weeks) in three other cases was accompanied by increases in precursor frequencies of graft-specific alloreactive T-cells; in one of them, the alloreactivity was preceded by a sharply increased autoreactivity to several islet autoantigens. One recipient had a delayed loss of islet graft function (33 weeks); he did not exhibit signs of graft-specific alloimmunity, but developed a delayed increase in autoreactivity. The parallel between metabolic outcome of human beta-cell allografts and cellular auto- and alloreactivity in peripheral blood suggests a causal relationship. The present study therefore demonstrates that T-cell reactivities in peripheral blood can be used to monitor immune mechanisms, which influence survival of beta-cell allografts in diabetic patients. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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