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Tissue Factor Produced by the Endocrine Cells of the Islets of Langerhans Is Associated With a Negative Outcome of Clinical Islet Transplantation

Authors :
Graciela Elgue
Helena Johansson
Lisa Moberg
Kristina Nilsson Ekdahl
Annika Tibell
Torbjörn Lundgren
Aksel Foss
Bo Nilsson
Kaija Salmela
C Berne
Ragnar Källén
Agneta Lukinius
Marie Felldin
Gunnar Tufveson
Olle Korsgren
Source :
Diabetes. 54:1755-1762
Publication Year :
2005
Publisher :
American Diabetes Association, 2005.

Abstract

There are strong indications that only a small fraction of grafts successfully engraft in clinical islet transplantation. One explanation may be the instant blood-mediated inflammatory reaction (IBMIR) elicited by tissue factor, which is produced by the endocrine cells. In the present study, we show that islets intended for islet transplantation produce tissue factor in both the transmembrane and the alternatively spliced form and that the membrane-bound form is released as microparticles often associated with both insulin and glucagon granules. A low–molecular mass factor VIIa (FVIIa) inhibitor that indirectly blocks both forms of tissue factor was shown in vitro to be a promising drug to eliminate the IBMIR. Thrombin-antithrombin complex (TAT) and FVIIa-antithrombin complex (FVIIa-AT) were measured in nine patients who together received 20 infusions of isolated human islets. Both the TAT and FVIIa-AT complexes increased rapidly within 15–60 min after infusion. When the initial TAT and FVIIa-AT levels were plotted against the increase in C-peptide concentration after 7 days, patients with an initially strong IBMIR showed no significant increase in insulin synthesis after 7 days. In conclusion, tissue factor present in both the islets and the culture medium and elicits IBMIR, which affects the function of the transplanted islets.

Details

ISSN :
1939327X and 00121797
Volume :
54
Database :
OpenAIRE
Journal :
Diabetes
Accession number :
edsair.doi.dedup.....42df6485b9e027afd78a27feaee17ad3
Full Text :
https://doi.org/10.2337/diabetes.54.6.1755