<p>Transplanting pancreatic islets into the liver through the portal vein is currently the most common procedure in clinical islet transplantations for treating patients with brittle type 1 diabetes. However, most islet grafts fail within a 5-year period necessitating retransplantation. The vascular connections are disrupted at islet isolation and implanted islets depend on diffusion of oxygen and nutrients in the immediate posttransplantation period. Rapid and efficient revascularization is of utmost importance for the survival and long-term function of transplanted islets. </p><p>In this thesis, the influence of the implantation microenvironment for islet engraftment and function was studied. Islets were transplanted into the liver, the renal subcapsular site or the pancreas. Islets implanted into the liver contained fewer glucagon-positive cells than islets implanted to the kidney and endogenous islets. Intraportally transplanted islets responded with insulin and glucagon release to secretagogues, but only when stimulated through the hepatic artery. Thus, the intrahepatic grafts were selectively revascularized from the hepatic artery. The vascular density in human islets transplanted into the liver of athymic mice was markedly lower when compared to human islets grafted to the kidney. Islets implanted into their physiological environment, the pancreas, were markedly better revascularized. Insulin content, glucose-stimulated insulin release, (pro)insulin biosynthesis and glucose oxidation rate were markedly decreased in transplanted islets retrieved from the liver, both when compared to endogenous and transplanted islets retrieved from the pancreas. Only minor changes in metabolic functions were observed in islets implanted into the pancreas when compared to endogenous islets. </p><p>The present findings demonstrate that the microenvironment has a major impact on the engraftment of transplanted islets. Elucidating the beneficial factors that promote engraftment would improve the survival and long-term function of transplanted islets. Ultimately, islet transplantation may be provided to an increased number of patients with type 1 diabetes.</p>

Transplanting pancreatic islets into the liver through the portal vein is currently the most common procedure in clinical islet transplantations for treating patients with brittle type 1 diabetes. However, most islet grafts fail within a 5-year period necessitating retransplantation. The vascular connections are disrupted at islet isolation and implanted islets depend on diffusion of oxygen and nutrients in the immediate posttransplantation period. Rapid and efficient revascularization is of utmost importance for the survival and long-term function of transplanted islets. In this thesis, the influence of the implantation microenvironment for islet engraftment and function was studied. Islets were transplanted into the liver, the renal subcapsular site or the pancreas. Islets implanted into the liver contained fewer glucagon-positive cells than islets implanted to the kidney and endogenous islets. Intraportally transplanted islets responded with insulin and glucagon release to secretagogues, but only when stimulated through the hepatic artery. Thus, the intrahepatic grafts were selectively revascularized from the hepatic artery. The vascular density in human islets transplanted into the liver of athymic mice was markedly lower when compared to human islets grafted to the kidney. Islets implanted into their physiological environment, the pancreas, were markedly better revascularized. Insulin content, glucose-stimulated insulin release, (pro)insulin biosynthesis and glucose oxidation rate were markedly decreased in transplanted islets retrieved from the liver, both when compared to endogenous and transplanted islets retrieved from the pancreas. Only minor changes in metabolic functions were observed in islets implanted into the pancreas when compared to endogenous islets. The present findings demonstrate that the microenvironment has a major impact on the engraftment of transplanted islets. Elucidating the beneficial factors that promote engraftment would improve the survival and long-term function of transplanted islets. Ultimately, islet transplantation may be provided to an increased number of patients with type 1 diabetes.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Précédemment, nous avons montré que la surexpression de l'échangeur Na/Ca NCX1), une protéine responsable de la sortie de calcium (Ca2+) des cellules, augmentait la mort cellulaire programmée ou « apoptose » et réduisait la prolifération des cellules β. Afin d’étudier plus en profondeur le rôle de l’échangeur dans les cellules β in vivo, nous avons développé et caractérisé des souris présentant une inactivation de NCX1.<p>Des méthodes biologiques et morphologiques (imagerie du Ca2+, capture de Ca2+, métabolisme du glucose, sécrétion d'insuline et morphométrie par comptage de points) ont été utilisées pour évaluer la fonction de la cellule β in vitro. Les taux de glucose et d'insuline dans le sang ont été mesurés afin de déterminer le métabolisme du glucose et la sensibilité à l’insuline in vivo. Des îlots ont été transplantés sous la capsule rénale pour évaluer leur capacité à corriger le diabète chez les souris rendues diabétiques par l’alloxane.<p>L'inactivation hétérozygote de Ncx1 chez les souris provoque une augmentation de la sécrétion d’insuline induite par le glucose avec un renforcement important à la fois de la première et de la deuxième phase. Ces résultats s’accompagnent d’une augmentation de la masse et de la prolifération des cellules β. La mutation augmente également le contenu en insuline, l’immunomarquage de la proinsuline, la capture de Ca2+ induite par le glucose et la résistance à l'hypoxie des cellules β. En outre, les îlots de souris Ncx1+/- montrent une capacité à compenser le diabète 2 à 4 fois plus élevé que les îlots de souris Ncx1+/+ lorsque transplantés chez des souris diabétiques.<p>En conclusion, l’inactivation de l'échangeur Na/Ca conduit à une augmentation de la fonction de la cellule β, de sa prolifération, de sa masse et de sa résistance au stress physiologique, à savoir à divers changements de fonction des cellules β opposés aux principales anomalies rencontrées dans le diabète de type 2 (Type 2 Diabetes Mellitus,T2DM). Ceci nous procure un modèle unique pour la prévention et le traitement du dysfonctionnement des cellules β dans le T2DM et pour la transplantation d'îlots.<p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Thesis (MScMedSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Diabetes Mellitus is a metabolic disease characterized by the loss of beta cells from the islets, thereby disrupting islet composition and architecture which are important components that influence islet function. The experimental technique of pancreatic duct ligation (PDL), which is thought to induce the regeneration of beta cells within the adult pancreas, was investigated as a novel treatment strategy for diabetes. This study aimed at investigating the possibility that the PDL model may have the capacity to restore normal islet composition and architecture in diabetic animals, which could make it an effective approach to reverse diabetes. Male Wistar rats (n=55) were divided into three study groups: the normal control (NC) group, the diabetic control (DC) group consisting of five subgroups (day 0, 3, 5, 10 and 30) and the experimental (EX) group consisting of four subgroups (day 3, 5, 10 and 30). The experimental group was exposed to PDL. All pancreata were divided into a P1 portion (proximal to the point of ligature) and P2 portion (distal to the point of ligature) for histological assessment. Animals’ non-fasting blood glucose levels (BGLs) and body weights were monitored. The general morphology of the tissue was studied, while an immunohistochemical (IHC) study was performed to determine insulin, pancreatic polypeptide, glucagon and somatostatin protein expression in the P1 and P2 portions of the pancreas. From the IHC slides hormone fractions, staining intensity and distribution were determined as indication of islet composition and architecture. Despite apparent morphological recovery in the islet 30 days post-PDL, islet composition and architecture remained disrupted. Compared to diabetic animals, the proximal portion of the pancreas in experimental animals had a decreased beta cell fraction and increased delta cell fraction thirty days following PDL. These observed changes in islet composition in the part of the pancreas proximal to the ligature are novel findings. There was no change in the diabetic islet composition in the portion of the pancreas distal to the ligature thirty days following PDL. Furthermore, pancreatic duct ligation did not restore body weight or normoglycemia. We conclude that STZ disrupts islet composition and architecture and this could not be restored using PDL; we therefore suggest that a comparative study using a Type 2 diabetic model, where there is limited damage to pre-existing beta cells, may yield different results. / AFRIKAANSE OPSOMMING: Diabetes Mellitus is ʼn metaboliese siekte wat deur die verlies van beta selle uit die eilande van Langerhans gekarakteriseer word. Hierdie verlies van beta selle ontwrig eiland komposisie en argitektuur, twee belangrike komponente van eiland funksie. Die eksperimentele tegnieke van pankreatiese buisafbinding (in Engels PDL), wat moontlik beta sel regenerasie in die volwasse pankreas kan induseer, is ondersoek as behandelings-strategie vir diabetes. Hierdie studie het ten doel gehad om die moontlikheid te ondersoek dat die PDL model die kapasiteit het om normale eiland komposisie en argitektuur te herstel in diabetiese diere, wat dit ʼn effektiewe benadering vir die omkeer van diabetes kan maak. Manlike Wistar rotte (n=55) was in 3 studie groepe verdeel: die normale kontrole (NC) groep, die diabetiese kontrole (DC) groep wat uit vyf subgroepe bestaan (dag 0, 3, 5, 10 en 30) en die eksperimentele (EX) groep wat uit vier subgroepe bestaan (dag 3, 5, 10 en 30). Die eksperimentele groep is aan PDL blootgestel. Alle pankreata is verdeel in ʼn P1 porsie (proksimaal tot die afbinding) en ʼn P2 porsie (distaal tot die afbinding) vir histologiese assessering. Die diere se nie-vastende bloed glukose vlakke en liggaamsgewig is gemonitor. Die algemene morfologie van die pankreas weefsel is bestudeer, terwyl ’n immunohistochemiese (IHC) studie gedoen is om insulien, pankreatiese polipeptied, glukagon en somatostatien proteïen uitdrukking in die P1 en P2 porsies van die pankreas te bepaal. Vanaf die IHC snitte is hormoon fraksie, kleur intensiteit en verspreiding bepaal as aanduidings van eiland komposisie en argitektuur. Ten spyte van ooglopende morfologiese herstel in die eilande op dag 30 na PDL, het eiland komposisie en argitektuur versteur gebly. In vergelyking met die diabetiese diere, het die proksimale deel van die pankreas van eksperimentele diere verlaagde beta sel fraksie en verhoogde delta sel fraksie getoon dertig dae na PDL. Die waarneming van veranderde komposisie in die deel van die pankreas proksimaal tot die afbinding is nuut. Daar was geen verandering in diabetiese eiland komposisie in die deel van die pankreas distaal tot die afbinding dertig dae na PDL nie. Verder het PDL nie liggaamsgewig of bloedsuiker genormaliseer nie. Ons gevolgtrekking is dat STZ eiland komposisie en argitektuur ontwrig en dat dit nie met PDL herstel kon word nie; daarom stel ons ʼn vergelykende studie in ʼn tipe 2 diabetes model voor, waar die skade aan reeds bestaande beta selle beperk is, wat ander resultate mag lewer.

Prevalence of type 2 diabetes mellitus (T2DM) is still rising and even so in the juvenile population. Obesity is highly associated with increased risk for developing T2DM. The development has been related to elevated fasting concentrations of the pancreatic islet hormones insulin and glucagon as well as to an increase in plasma lipids that occurs during obesity. Specifically, research has indicated that chronic exposure to high levels of saturated free fatty acids cause dysfunction in islet alpha- and beta-cells. Fatty acids can affect islet cells by various mechanisms one of which is the G-protein coupled receptor FFAR1/GPR40. The role of the receptor in the effects of fatty acids on pancreatic islet-cell function is not clear. The aim of this thesis was to clarify the role of FFAR1 in how fatty acids, and more specifically the long-chain saturated fatty acid palmitate, affect insulin and glucagon secretion. In children and adolescents with obesity elevated fasting levels of insulin and glucagon were positively correlated with lipid parameters. Specifically, plasma triglycerides and free fatty acids were positively correlated with insulin and glucagon at fasting as well as with visceral adipose tissue volume. Elevated glucagon levels at fasting were associated with worsening of glucose tolerance in the same population. In in vitro studies of isolated human islets palmitate stimulated basal insulin and glucagon secretion as well as mitochondrial respiration at fasting glucose levels. The effect was mediated by FFAR1 and fatty acid beta-oxidation. At higher glucose concentrations the receptor was involved in the potentiation of insulin secretion from isolated human islets and insulin-secreting MIN6 cells. Furthermore, we found that the effects of palmitate on hormone secretion were associated with enhanced mitochondrial respiration mediated by FFAR1 Gαq signaling and PKC activity as well as increased intracellular metabolism induced by the fatty acid. When islets were exposed to palmitate for long time periods and in the presence of FFAR1 antagonist, normalized insulin and glucagon secretion during culture and insulin response to glucose after culture were observed. In MIN6 cells chronic palmitate treatment increased mitochondrial uncoupling irrespective of FFAR1 involvement. However, FFAR1 antagonism during palmitate exposure resulted in elevated respiration and reduced apoptosis. In conclusion, children and adolescents with obesity have elevated fasting concentrations of insulin and glucagon that correlate with free fatty acids and fatty acid sources. High glucagon levels are linked to worsening of glucose tolerance in these subjects. In vitro the combination or synergy of FFAR1 activation and intracellular metabolism caused by palmitate is decisive for both the short-term enhancement effects and the negative chronic effects on insulin and glucagon secretion.

Den här studien tar upp problematiken med fragmentering och dess påverkan på arters spridning och förekomst. Huvudsyftet med studien var att testa teorin om öbiogeografi genom att undersöka förekomsten av ett antal kärlväxter på olika åkerholmar med olika avstånd till närmaste spridningskälla i form av ett bryn i en närliggande skog. Vi har inventerat 40 stycken par av åkerholmar (öar) och skogsbryn (fastland) i ett jordbrukslandskap i Stockholms län. Inventeringsresultatet har analyserats med hjälp av univeriata linjära modeller-, och multiveriat ordination. Resultatet visar att teorin om öbiogeografi bara delvis kan förklara förekomstmönster för kärlväxter på åkerholmar. Vidare fann vi att spridningen av arter begränsas av åkerholmens storlek. Avstånd hade en effekt på artsammansättningen på åkerholmar. Vårt resultat visar på ett behov av att se till fragmentsstorlek samt grad av isolering som viktiga faktorer som styr möjligheten för att arter i framtiden ska kunna sprida sig till nya habitat. / This study address the problem of fragmentation, and its impact on species distribution and abundance. The main aim of the study was to test the theory of island biogeography using plant species prevalence from field islets at different distances from nearest “mainland”. We have studied 40 pairs of field islets (islands) and forest edges (mainland) in agricultural landscapes in the Stockholm County. The result of the inventory was analyzed using univariate linear models-, and multivariate ordination. Our result show that the theory of island biogeography partly can explain species prevalence patterns, but not all of them. Furthermore, we found that species distributions were limited by the size of the field islets. Distance from mainland had an effect on the species composition in the field islets. Our results indicate a need to include the size of habitat fragments, and the degree of isolation as important factors determining the ability for future species dispersal to newly established habitats.

Type 1 diabetes (T1D) results from a loss of functional insulin-producing pancreatic beta cells. The etiology of T1D is poorly understood, but the detection of infiltrating inflammatory cells in the pancreas and circulating autoantibodies has led to the common notion that an autoimmune process plays a central role in the pathogenesis of the disease. The aim of this doctoral thesis was to assess various aspects of the immunopathology of type 1 diabetes. To this purpose, studies have been conducted on pancreatic material from the Network for Pancreatic Organ Donors with Diabetes (nPOD) collection, the Nordic Network for Islet Transplantation, and the Diabetes Virus Detection (DiViD) study. Paper I is a study on pancreatic tissue from organ donors with varying duration of T1D as well as non-diabetic donors and subjects with other types of diabetes, in which persistent expression of glucose transporters was shown on the beta cell membrane despite several years of T1D. Glucose transporter 1 was also confirmed as the predominant glucose transporter on human pancreatic islets. In paper II, we report on signs of inflammation in the exocrine but not in the endocrine pancreas in non-diabetic organ donors with diabetes-related autoantibodies, suggesting that diabetes-associated autoantibodies can occur in response to unspecific pancreatic lesions. Paper III aimed to characterize the T cell-infiltration of pancreatic islets in material from recent-onset T1D patients. Insulitis was shown in all subjects, but with distinct differences in expression analysis of T- and B cell activation to cell-mediated allorejected kidney transplant. Also Paper IV was conducted on material from recent-onset cases and showed increased islet glucagon content, in combination with a reduced number of islets but sustained mean islet size. Together, these results provide expansion of our knowledge of the immunopathology in T1D, and will hopefully assist in bringing us towards a deeper understanding of T1D aetiology and eventually an effective cure.

Acredita-se que a diminuição progressiva da massa de células observada durante a evolução do diabetes mellitus tipo 2 (DM 2) ocorra por apoptose deste tipo celular. As tiazolidinedionas (TZDs), uma classe de medicamentos utilizada no tratamento do DM 2, atuam como ligantes dos receptores ativados por proliferadores de peroxissomos (PPAR) e e promovem diminuição da resistência periférica à insulina. Embora existam estudos controversos, tem se especulado que as TZDs possam exercer efeitos diretos sobre as células pancreáticas, prevenindo a perda por apoptose e melhorando a sua viabilidade. O objetivo deste estudo foi avaliar os efeitos diretos da Pioglitazona (PIO) na concentração de 10 M sobre a viabilidade funcional e o índice de apoptose de ilhotas pancreáticas isoladas de ratos Wistar expostas a concentrações fisiológica (5,6 mM) e suprafisiológica (23 mM) de glicose durante 24, 48 e 72 horas. A viabilidade funcional foi avaliada pela análise da secreção de insulina estimulada por glicose e do conteúdo total de insulina nas ilhotas. O índice de apoptose foi avaliado pela medida da fragmentação do DNA, da expressão do RNAm dos genes Bcl2 (anti-apoptótico) e Bax (pró-apoptótico) e da atividade proteolítica da caspase-3 em ilhotas tratadas e não tratadas com a PIO. Em 5,6 mM de glicose, não se observou efeito significativo sobre a secreção de insulina, mas a avaliação do conteúdo total de insulina evidenciou uma diminuição transitória nas ilhotas tratadas com PIO por 24 horas, seguida por um aumento no conteúdo de insulina quando as ilhotas foram cultivadas por 48 e 72 horas em presença da droga. Em relação à avaliação da apoptose, observou-se uma diminuição na expressão do RNAm do gene Bax nas ilhotas tratadas com PIO por 24 horas, entretanto, após 48 e 72 horas, houve um aumento da expressão do RNAm deste gene nas ilhotas tratadas com a droga. Não foram observadas diferenças estatisticamente significativas na expressão do RNAm do gene Bcl2 em nenhum dos tempos estudados e a avaliação da apoptose determinada pela medida da fragmentação do DNA somente demonstrou uma diminuição do índice de apoptose após 48 horas de tratamento com a PIO. Em 23 mM de glicose, a PIO promoveu um aumento transitório na secreção de insulina estimulada por glicose e no conteúdo total de insulina (após 48 horas), no entanto, após 72 horas, observou-se diminuição significativa no conteúdo total de insulina. Em relação à apoptose, o tratamento com PIO determinou um aumento do índice de apoptose medido pela fragmentação do DNA e da atividade proteolítica da caspase-3 após 48 e 72 horas e uma diminuição da expressão do RNAm do gene Bcl2 nos tempos 24 e 48 horas. Os resultados do presente estudo sugerem que os efeitos diretos da PIO sobre as ilhotas pancreáticas murídeas em cultura variam de acordo com a concentração de glicose a qual as ilhotas estão expostas: em concentração fisiológica de glicose, a PIO parece exercer efeitos diretos benéficos, enquanto em concentração suprafisiológica de glicose, ela exerce efeitos diretos deletérios sobre a viabilidade funcional e o índice de apoptose de ilhotas pancreáticas murídeas em cultura. / The progressive decrease in -cell mass observed during the evolution of type 2 diabetes (T2DM) is believed to occur due to cell apoptosis. Thiazolidinediones (TZDs), a class of agents used for the treatment T2DM, act as ligands of the peroxisome proliferator-activated receptor (PPAR) and and decrease peripheral insulin resistance. Although still controversial, some studies have shown a direct effect of TZDs on pancreatic -cell, preventing cell loss due to apoptosis and improving their viability. The objective of this study was to evaluate the direct effects of 10 M Pioglitazone (PIO) on functional viability and apoptosis rate of islets isolated from Wistar rats exposed to physiological (5.6 mM) and supraphysiological (23 mM) glucose concentrations during 24, 48 and 72 hours. The functional viability was evaluated by the analysis of insulin secretion after glucose challenge and of islet total insulin content. Apoptosis rate was evaluated by measurement of DNA fragmentation, of Bcl2 (antiapoptotic) and Bax (proapoptotic) mRNA expression and of proteolytic activity of caspase-3 in pancreatic islets treated or not with PIO. At 5.6 mM glucose concentration, no significant effects in insulin secretion were observed, while a transitory decrease (after 24 hours) followed by an increase in total insulin content was observed in islets treated with PIO for 48 and 72 hours. Regarding apoptosis, a lower expression of Bax mRNA was detected in islets treated with PIO for 24 hours, followed, however, by an increase in the expression of this gene after 48 and 72 hours of drug exposition. PIO treatment did not promote significant changes in Bcl2 mRNA expression, while decreased the apoptosis rate measured by DNA fragmentation only after 48 hours of exposition. At 23 mM glucose concentration, PIO treatment elicited a transitory increase in insulin secretion after glucose challenge and in islet total insulin content after 48 hours followed by a decrease in the islet total insulin content after 72 hours. Concerning apoptosis, PIO treatment determined an increase in the apoptose rate measured by DNA fragmentation and by proteolytic activity of caspase-3 after 48 and 72 hours and a decrease in Bcl2 mRNA expression after 24 and 48 hours. These findings suggest that the direct effects of PIO on pancreatic islets depend on glucose concentration to which they are exposed: while under physiological glucose concentration the direct effects seem to be beneficial, under supraphysiological glucose concentration, PIO exerts direct deleterious effects on the functional viability and on the apoptosis rate of murine pancreatic islets.

BMPs ocupam papel central na diferenciação e crescimento celulares. A sinalização intracelular das BMPs depende de substratos conhecidos como BR-SMADs (SMAD1/5/8). Em ilhotas pancreáticas de ratas grávidas, onde ocorre aumento da massa endócrina e da síntese e secreção de insulina, houve aumento da expressão do receptor BMPR1A. Em camundongos knockout para BMPR1A houve diminuição da expressão de genes-chave na exocitose de grânulos de insulina. Tais eventos estão associados à redução da atividade das BR-SMADs. O objetivo deste trabalho foi avaliar, em células <font face=\"Symbol\">b INS1E, o perfil de expressão gênica em larga escala após silenciamento das BR-SMADs. As expressões relativas de Munc18a, Munc18b e Snap23 foram reduzidas quando do silenciamento das BR-SMADs (n=3, p<0,05 vs CTL). O silenciamento de SMAD1 (n=3, p<0,05 vs CTL) ou SMAD5 (n=3, p<0,05 vs CTL) acarretaram redução do mRNA de Sintaxina 4. Conclui-se que as BR-SMADs estão envolvidas na regulação da secreção de insulina modulando proteínas envolvidas na fusão de vesículas contendo grânulos de insulina à membrana plasmática de células INS1E. / BMPs play a determinant role in cell differentiation and growth. BMP intracellular signaling involves the substrates know as BR-SMADs (SMAD1/5/8). BMPR1A receptor expression was upregulated in pancreatic islets from pregnant rats, in wich endocrine mass and insulin secretion are increased. Mice with attenuated BMPR1A signaling in <font face=\"Symbol\">b cells showed decreased expression of key genes involved in insulin exocytosis. These events are associated with reduction of BR-SMADs activity. The aim of this work was to perform a screening to evaluate changes in expression profiles after knockdown of BR-SMADs in INS1E <font face=\"Symbol\">b cells. Relative expressions of Munc18a, Munc18b and Snap23 were diminished after knockdown of the BRSMADs (n=3, p<0,05 vs CTL). Only SMAD1 (n=3, p<0,05 vs CTL) and SMAD5 (n=3, p<0,05 vs CTL) silencing caused reduction of sintaxin 4 expression. These data point to the involvement of BR-SMADs in the regulation of insulin secretion by modulating the expression of proteins responsible by fusion of insulin-containing granules to the membrane of INS1E cells.