Pancreatic B-cell culture after intravitam B-cell selection with nitric pilocarpine and modified B-technique use.

Our purpose was intravitam selection of endocrine pancreatic tissue. We decided to use 3% nitric pilocarpine as oral treatment for normal Wistar rats. This experiment was made on 12 male normal Wistar rats, 8 of them receiving 0.025 ml 3% nitric pilocarpine in a single daily dose, for 7 days. In the next 3-4 days, all of these have demonstrated clinical picture of exocrine pancreatic failure leading finally to death. Animals have received ad libitum food-intake. During this period, the study group has demonstrated glycemia values between 65...75 mg/dl vs. 68...85 mg/dl for normal group. The histological picture of study group's pancreatic pieces demonstrated intensive necrobiotic changes for exocrine components, but normal features for the exocrine ones. Furthermore we have obtained primary monolayer cultures of this dominant B-cell tissue, using a modified B-technique. Our results demonstrated the greatest percentage of B-cells on the cultures, in comparison with the non-using pilocarpine method (other studies). The presence of mega-beta-islet cells in primary cultures, as well as the lack of fibroblast population, demonstrated the efficiency of this method.

Not only quantitative but also qualitative changes of serum immunoglobulins in diabetes mellitus.

To extend previous observations on the quantitative changes of IgA and other serum Ig in diabetics, additional immunochemical investigations were carried out in 96 patients, 63 males and 33 females, mean age 43.5 +/- 15.7 years, 51 with type 1 (insulin-dependent) and 45 with type 2 (non-insulin-dependent) diabetes. The immunological data were correlated with the clinical-metabolic aspects. In the whole group, the IgA level was increased (144.1 +/- 57.2 I.U.). Significant differences were recorded with respect to age for IgG, to age and diabetes type for IgA, to sex for IgM. Qualitative Ig changes, reflecting disturbances of molecular structure, mainly for IgG, seldom for IgM, but never for IgA, were observed in 20% of the patients with both types of diabetes, more seldom in cases with long disease duration. The IgG with qualitative changes were purified and their functional capacity of inhibiting the natural cytotoxic activity (NK) was tested in comparison with that induced by pretreatment of the effectory cells with normal IgG. Some of these modified IgG showed a reduced capacity of inhibiting the NK activity. These data confirm the existence of certain quantitative changes of the main serum Ig in diabetics and reveal the presence of qualitative disorders of the IgG molecules, with consequences on their functionality.

Pancreas transplantation. Experimental and clinical trials.

The ever increasing incidence of diabetes mellitus has stimulated the immunologic investigations concerned with the role of heredity and the toleration rate of transplants of pancreas organ or islet structures. Concomitant or subsequent trials have attempted to define or avoid the apparently diabetogenic factors. With respect to the effectiveness of diabetes therapy, one cannot deny the contrast between the practical and the theoretical aspects. Besides the technical difficulties, the pancreas organ or islet cell transplants are confronted with the still limited possibilities of immunosuppression. The recent concept of a bioartificial organ is an attempt to avoid such disadvantages. The present paper is a review of the main achievements of the experimental and the clinical trials in the above-mentioned directions of research work.

Is microalbuminuria a different problem for type I and type II diabetes mellitus?

As in previous studies an improved single radial immunodiffusion technique was used for albumin, calculating the albumin/creatinine ratio in spot urine (mg/g/1.73 m2). This ratio was 4.7 +/- 0.0174 (geometric mean +/- SEM as logarithm) in 130 healthy controls, the highest value being 10.8. The 182 non-selected ambulatory diabetic patients presented three subgroups, each showing a non-gaussian frequency distribution: 47% with normal values (5.0 +/- 0.0224); 42% with ratio values from 11.0 to 88.8 (22.7 +/- 0.0269, significantly differing from the controls); 11% with clinical proteinuria (subsequently excluded from the study). Type I (9.6 +/- 0.0452; n = 76) and type II diabetic patients (10.7 +/- 0.0430; n = 86) significantly differed (p less than 0.001) from the controls but not from one another. Irrespective of the diabetes type, ratio values were significantly correlated with the duration of diabetes, age of patients, age of diagnosis (for instance 16.2 +/- 0.0974 in 15 patients aged greater than 65 years versus 9.1 +/- 0.0792 in 23 patients aged less than 20 years), glycemia level and chronic complications (especially retinopathy). Therefore, more than half the diabetic patients, non-selected, presented an increased albumin excretion as compared to the controls. On the other hand, microalbuminuria appears to be linked to age, duration of the disease and quality of the metabolic control rather than to the diabetes type.