       Document 0619
 DOCN  M9620619
 TI    [Human fetal pancreatic islet transplantation in insulin-dependent
       diabetics: possibilities of early detection of transplant destruction]
 DT    9602
 AU    Djordjevic PB; Brkic S; Lalic NM; Zamaklar M; Dragasevic M; Radovic Z;
       Popovic S; Banovic D; Dimitrijevic V; Savic K; et al; Institute for
       Endocrinology, Diabetes and Metabolic Diseases,; University Clinical
       Center, Belgrade, Yugoslavia.
 SO    Glas Srp Akad Nauka [Med]. 1994;(44):83-8. Unique Identifier : AIDSLINE
       MED/96021697
 AB    The factors determining the outcome of human fetal islet transplantation
       in patients with insulin-dependent diabetes mellitus (IDDM) remain
       unclarified. In this study we analysed the ratio between
       immunoregulatory lymphocyte subpopulations in order to search for a
       possible marker of the immune destruction of transplanted islets. Human
       fetal islets were isolated by collagenase digestion, cultured for 14
       days at 37 degrees C, 5% CO2, and implanted under fascia of m. rectus
       abdominis in 7 IDDM patients (5 pancreata per patient). After
       transplantation we evaluated simultaneously the level of metabolic
       control through HbA1c values determined by chromatography, the capacity
       of insulin secretion through the C-peptide levels (determined by
       radioimmunoassay) before and 6 minutes after 1 mg glucagon i.v.
       stimulation, and the ratio between CD4+ and CD8+ lymphocytes determined
       by immunofluorescence using monoclonal antibodies. We found that
       metabolic control after transplantation was improved together with the
       decrease of the insulin daily dose, and the improvement was simultaneous
       to the increase of both basal and glucagon-stimulated C-peptide levels.
       Four months after transplantation we detected a remarkable decrease in
       the secretion capacity, accompanied by the necessity for an increase in
       daily insulin dose to maintain optimal metabolic control. However, the
       loss of islet function was preceded by the increase in CD4+/CD8+ ratio,
       thus reflecting the presumable accumulation of CD4+ inducer
       T-lymphocytes. When the islet secretion capacity was destroyed, we found
       a decrease in CD4+/CD8+ ratio, reflecting the recruitment of CD8+
       effector cells.(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Adult  CD4-CD8 Ratio  Diabetes Mellitus,
       Insulin-Dependent/IMMUNOLOGY/PHYSIOPATHOLOGY/  *SURGERY  English
       Abstract  Female  *Fetal Tissue Transplantation  *Graft Survival  Human
       Insulin/SECRETION  Islets of Langerhans/EMBRYOLOGY/SECRETION  *Islets of
       Langerhans Transplantation  Male  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

