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1.
J Gastrointest Oncol ; 15(3): 890-907, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38989426

RESUMO

Background: Gastric cancer (GC), a multifaceted gastrointestinal malignancy, is the fourth most prevalent contributor to cancer-related fatalities globally. As a member of the ATP-binding cassette (ABC) family, transporter associated with antigen processing 1 (TAP1) is crucial for conveying antigen peptides from the cytoplasm to the lumen of the endoplasmic reticulum and subsequently loading them onto the major histocompatibility complex (MHC) class I molecules. Recent studies have established the biological significance of TAP1 in upholding tumor survival and facilitating immune evasion by remodeling the tumor microenvironment (TME) and orchestrating immune infiltration. The study was conducted to elucidate the association of TAP1 expression with immunological characteristics, and sought to exploit the value of TAP1 as a biomarker reflecting the inflamed TME and immunotherapeutic response. Methods: RNA-sequencing profiles and clinical annotations were obtained from The Cancer Genome Atlas-stomach adenocarcinoma (TCGA-STAD) cohort and Gene Expression Omnibus (GEO) portal. Preprocessing was conducting using the limma package. Weighted gene co-expression network analysis (WGCNA) was used to identify gene modules and TAP1 co-expressed genes (CEGs) based on correlation patterns. Consensus clustering and silhouette analysis determined the optimal number of TAP1-related groups. Gene expression profiles were integrated and classified using the pamr package. The Estimation of STromal and Immune cells in MAlignant Tumors using Expression data (ESTIMATE) algorithm and single-sample gene set enrichment analysis (ssGSEA) were used to evaluate immunological characteristics. Differential expression analysis was conducted using the limma package. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed. Single-cell RNA sequencing (scRNA-seq) datasets were analyzed using the Seurat toolkit to characterize cell types. Results: Within this investigation, no significant differences in TAP1 expression were observed among patients exhibiting various clinicopathological features, indicating that TAP1 expression was not specific to molecular subtypes. Subsequent analysis revealed a positive correlation between TAP1 and diverse immunological traits, encompassing immunomodulators, tumor-infiltrating immune cells, as well as immune checkpoints across multiple datasets. Besides, within a GC immunotherapy cohort, individuals displaying high TAP1 expression demonstrated an increased likelihood of achieving complete remission (CR) post-treatment, suggesting heightened sensitivity to immunotherapy. In the clinical cohort, TAP1 overexpression in GC patients was positively correlated with CD8. Conclusions: TAP1 appears linked to an inflamed TME and serves as a prospective biomarker for discerning immunological attributes and gauging immunotherapeutic responses in GC, particularly in identifying immune-reactive tumors.

2.
Small ; : e2403553, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38845013

RESUMO

Eumelanin, a natural, biocompatible, and biodegradable photothermal agent derived from biomass, has attracted increasingly considerable attention due to its outstanding photothermal conversion efficiency. Unfortunately, its tendency to aggregate in flexible non-polar polymers, owing to its abundant polar groups on the surface, severely restricted the application of eumelanin in photothermal composite field. Herein, a feasible strategy is proposed to disperse eumelanin in non-polar rubber matrix via in situ generation of Zinc dimethacrylate (ZDMA). The graft-polymerization of ZDMA promotes the interfacial compatibility between styrene butadiene rubber (SBR) and eumelanin, achieving a uniform dispersion of eumelanin in SBR. The rubber composite exhibits a considerable tensile strength of 11.4 MPa, acceptable elongation at break of 146%, and outstanding photothermal conversion efficiency of up to 75.2% with only 1 wt% of eumelanin. Furthermore, based on the easy-processing of SBR matrix, the composite is treated with a sandpaper template technique and sprayed with trimethoxy(1H,1H,2H,2H-perfluorodecyl)silane (PFDTMS) to endow the material with near superhydrophobicity (water contact angle of 147.9°) capacity. Hydrophobicity provides excellent icing resistance, with droplet surfaces extending more than twice as long to freeze. Moreover, this hydrophobic photothermal material exhibits remarkable anti-frosting, de-frosting, and de-icing capabilities.

3.
Front Immunol ; 15: 1421092, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38911856

RESUMO

Immune checkpoint blockades (ICBs) have revolutionized cancer therapy through unleashing anti-tumor adaptive immunity. Despite that, they are usually effective only in a small subset of patients and relapse can occur in patients who initially respond to the treatment. Recent breakthroughs in this field have identified innate immune checkpoints harnessed by cancer cells to escape immunosurveillance from innate immunity. MHC1 appears to be such a molecule expressed on cancer cells which can transmit a negative signal to innate immune cells through interaction with leukocyte immunoglobulin like receptor B1 (LILRB1). The review aims to summarize the current understanding of MHC1/LILRB1 axis on mediating cancer immune evasion with an emphasis on the therapeutic potential to block this axis for cancer therapy. Nevertheless, one should note that this field is still in its infancy and more studies are warranted to further verify the effectiveness and safety in clinical as well as the potential to combine with existing immune checkpoints.


Assuntos
Imunidade Inata , Receptor B1 de Leucócitos Semelhante a Imunoglobulina , Neoplasias , Humanos , Receptor B1 de Leucócitos Semelhante a Imunoglobulina/metabolismo , Receptor B1 de Leucócitos Semelhante a Imunoglobulina/imunologia , Neoplasias/imunologia , Neoplasias/terapia , Animais , Inibidores de Checkpoint Imunológico/uso terapêutico , Evasão Tumoral , Antígenos de Histocompatibilidade Classe I/imunologia , Antígenos de Histocompatibilidade Classe I/metabolismo , Imunoterapia/métodos , Transdução de Sinais , Antígenos CD
4.
ACS Macro Lett ; 12(8): 1144-1150, 2023 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-37503885

RESUMO

Herein, we originally developed a fused ring building block as an acceptor unit, namely, 2,6,10-trihydro-carbazole[3,4-c:5,6-c]bis[1,2,5]-triazole (CTA), through fusing two benzotriazoles (BTA) with a pyrrole ring. A p-type polymer PE93 containing the CTA unit exhibits relatively high molecular energy levels and excellent luminescent properties. The PE93:BTA76-based solar cell obtained a device efficiency of 12.16%, with a VOC of 0.94 V and a low nonradiative recombination loss of 0.18 eV. The results suggest that the CTA unit is an efficient acceptor unit to achieve excellent photovoltaic performance.

5.
Front Oncol ; 13: 1086604, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36937389

RESUMO

Introduction: Hepatocellular carcinoma (HCC) is an aggressive malignancy with steadily increasing incidence rates worldwide and poor therapeutic outcomes. Studies show that metabolic reprogramming plays a key role in tumor genesis and progression. In this study, we analyzed the metabolic heterogeneity of epithelial cells in the HCC and screened for potential biomarkers. Methods: The hepatic single-cell RNA sequencing (scRNA-seq) datasets of HCC patients and healthy controls were obtained from the Gene Expression Omnibus (GEO) database. Based on data intergration and measurement of differences among groups, the metabolic epithelial cell subpopulations were identified. The single-cell metabolic pathway was analyzed and the myeloid subpopulations were identified. Cell-cell interaction analysis and single-cell proliferation analysis were performed. The gene expression profiles of HCC patients were obtained from the GSE14520 dataset of GEO and TCGA-LIHC cohort of the UCSC Xena website. Immune analysis was performed. The differentially expressed genes (DEGs) were identified and functionally annotated. Tumor tissues from HCC patients were probed with anti-ALDOA, anti-CD68, anti-CD163, anti-CD4 and anti-FOXP3 antibodies. Results We analyzed the scRNA-seq data from 48 HCC patients and 14 healthy controls. The epithelial cells were significantly enriched in HCC patients compared to the controls (p = 0.011). The epithelial cells from HCC patients were classified into two metabolism-related subpopulations (MRSs) - pertaining to amino acid metabolism (MRS1) and glycolysis (MRS2). Depending on the abundance of these metabolic subpopulations, the HCC patients were also classified into the MRS1 and MRS2 subtype distinct prognoses and immune infiltration. The MRS2 group had significantly worse clinical outcomes and more inflamed tumor microenvironment (TME), as well as a stronger crosstalk between MRS2 cells and immune subpopulations that resulted in an immunosuppressive TME. We also detected high expression levels of ALDOA in the MRS2 cells and HCC tissues. In the clinical cohort, HCC patients with higher ALDOA expression showed greater enrichment of immunosuppressive cells including M2 macrophages and T regulatory cells. Discussion: The glycolytic subtype of HCC cells with high ALDOA expression is associated with an immunosuppressive TME and predicts worse clinical outcomes, providing new insights into the metabolism and prognosis of HCC.

6.
Front Plant Sci ; 14: 1343402, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38312353

RESUMO

Introduction: Trehalose is vital for plant metabolism, growth, and stress resilience, relying on Trehalose-6-phosphate synthase (TPS) and Trehalose-6-phosphate phosphatase (TPP) genes. Research on these genes in cultivated peanuts (Arachis hypogaea) is limited. Methods: This study employed bioinformatics to identify and analyze AhTPS and AhTPP genes in cultivated peanuts, with subsequent experimental validation of AhTPS9's role in cold tolerance. Results: In the cultivated peanut genome, a total of 16 AhTPS and 17 AhTPP genes were identified. AhTPS and AhTPP genes were observed in phylogenetic analysis, closely related to wild diploid peanuts, respectively. The evolutionary patterns of AhTPS and AhTPP genes were predominantly characterized by gene segmental duplication events and robust purifying selection. A variety of hormone-responsive and stress-related cis-elements were unveiled in our analysis of cis-regulatory elements. Distinct expression patterns of AhTPS and AhTPP genes across different peanut tissues, developmental stages, and treatments were revealed, suggesting potential roles in growth, development, and stress responses. Under low-temperature stress, qPCR results showcased upregulation in AhTPS genes (AhTPS2-5, AhTPS9-12, AhTPS14, AhTPS15) and AhTPP genes (AhTPP1, AhTPP6, AhTPP11, AhTPP13). Furthermore, AhTPS9, exhibiting the most significant expression difference under cold stress, was obviously induced by cold stress in cultivated peanut, and AhTPS9-overexpression improved the cold tolerance of Arabidopsis by protect the photosynthetic system of plants, and regulates sugar-related metabolites and genes. Discussion: This comprehensive study lays the groundwork for understanding the roles of AhTPS and AhTPP gene families in trehalose regulation within cultivated peanuts and provides valuable insights into the mechanisms related to cold stress tolerance.

7.
Front Bioeng Biotechnol ; 11: 1329959, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38370870

RESUMO

Ischemic stroke (IS) refers to local brain tissue necrosis which is caused by impaired blood supply to the carotid artery or vertebrobasilar artery system. As the second leading cause of death in the world, IS has a high incidence and brings a heavy economic burden to all countries and regions because of its high disability rate. In order to effectively treat IS, a large number of drugs have been designed and developed. However, most drugs with good therapeutic effects confirmed in preclinical experiments have not been successfully applied to clinical treatment due to the low accumulation efficiency of drugs in IS areas after systematic administration. As an emerging strategy for the treatment of IS, stimuli-responsive nanomedicines have made great progress by precisely delivering drugs to the local site of IS. By response to the specific signals, stimuli-responsive nanomedicines change their particle size, shape, surface charge or structural integrity, which enables the enhanced drug delivery and controlled drug release within the IS tissue. This breakthrough approach not only enhances therapeutic efficiency but also mitigates the side effects commonly associated with thrombolytic and neuroprotective drugs. This review aims to comprehensively summarize the recent progress of stimuli-responsive nanomedicines for the treatment of IS. Furthermore, prospect is provided to look forward for the better development of this field.

8.
ACS Appl Mater Interfaces ; 14(36): 41296-41303, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36052498

RESUMO

Compared with other all-inorganic/organic-inorganic hybrid solar cells, the large voltage loss (Vloss) of organic photovoltaic (OPV) cells, especially the nonradiative voltage loss (ΔVnonrad), limited the further improvement of performance. Although A-DA'D-A-type Y-series nonfullerene acceptors (NFAs) largely improve the power conversion efficiencies (PCEs) to 18%, the open-circuit voltage (VOC) of this kind of material was still restricted to below 1.0 V. Herein, we designed and synthesized a narrow bandgap (Eg = 1.41 eV) acceptor BTA77 with an A-DA'D-A-type backbone containing a nonhalogenated terminal group to achieve high electroluminescence efficiency and high VOC. Combined with the nonhalogenated polymer PBDB-T with a conjugated thiophene side chain, BTA77 realized a VOC of 0.944 V, a Vloss of 0.552 V, and a PCE of 13.75%, which is one of the highest PCEs based on nonhalogenated A-DA'D-A-type acceptors with VOC > 0.9 V. After further blending with the nonhalogenated donor polymer PBT1-C with a conjugated phenyl side chain, the VOC increases to 1.021 V with a super low ΔVnonrad of 0.14 V owing to the greatly improved electroluminescence external quantum efficiency (EQEEL) of 4.42 × 10-3. Our results indicate that there is still a large room to decrease the ΔVnonrad and increase VOC by synergistic molecular engineering of p-type polymers and n-type small molecules.

9.
Contrast Media Mol Imaging ; 2022: 8950600, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35800234

RESUMO

This study aimed to discuss the application value of the bias field correction algorithm in magnetic resonance imaging (MRI) images of patients with primary hepatic carcinoma (PHC). In total, 52 patients with PHC were selected as the experimental group and divided into three subgroups: mild (15 cases), moderate (19 cases), and severe (18 cases) according to pathological grading. Another 52 patients with hepatic nodules in the same period were included in the control group. All the patients underwent dynamic contrast-enhanced (DCE) MRI examination, and the image qualities of MRI before and after bias field correction were compared. The DCE-MRI perfusion parameters were measured, including the transport constant Ktrans, reverse rate constant Kep, extravascular extracellular volume fraction (Ve), plasma volume (Vp), microvascular density (MVD), hepatic artery perfusion index (HPI), mean transit time of contrast agent (MTT), time to peak (TTP), blood volume (BV), hepatic arterial perfusion (HAP), full perfusion (FP), and portal venous perfusion (PVP). It was found that the sensitivity (93.63%), specificity (71.62%), positive predictive value (95.63%), negative predictive value (71.62%), and accuracy (90.01%) of MRI examination processed by the bias field correction algorithm were all significantly greater than those before processing (P < 0.05). The Ktrans, Kep, Ve, Vp, and MVD of patients in the experimental group were significantly larger than those of the control group, and severe group> moderate group> mild group (P < 0.05). HPI, MTT, TTP, BV, and HAP of patients in the experimental group were also significantly greater than those of the control group, which was shown as severe group > moderate group > mild group (P < 0.05). FP and PVP of the experimental group were significantly lower than those of the control group, and severe group < moderate group < mild group (P < 0.05). It was suggested that in MRI images of patients with PHC, the bias field correction algorithm could significantly improve the diagnosis rate. Each perfusion parameter was related to the pathological grading, which could be used to evaluate the prognosis of patients.


Assuntos
Inteligência Artificial , Carcinoma , Algoritmos , Meios de Contraste , Humanos , Imageamento por Ressonância Magnética/métodos
10.
Macromol Rapid Commun ; 43(22): e2100810, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35080281

RESUMO

Molecular structural modifications are utilized to improve the short-circuit current (JSC ) of high-voltage organic photovoltaics (OPVs). Herein, the classic non-fullerene acceptor (NFA), BTA3, is chosen as a benchmark, with BTA3b containing the linear alkyl chains on the middle core and JC14 fusing thiophene on the benzotriazole (BTA) unit as a contrast. The photovoltaic devices based on J52-F: BTA3b and J52-F: JC14 achieve wider external quantum efficiency responses with band edges of 730 and 800 nm, respectively than that of the device based on J52-F: BTA3 (715 nm). The corresponding  JSC increases to 14.08 and 15.78 mA cm-2 , respectively, compared to BTA3 (11.56 mA cm-2 ). The smaller Urbach energy and higher electroluminescence efficiency guarantee J52-F: JC14 a decreased energy loss (0.528 eV) and a high open-circuit voltage (VOC ) of 1.07 V. Finally, J52-F: JC14 combination achieves an increased power conversion efficiency (PCE) of 10.33% than that of J52-F: BTA3b (PCE = 9.81%) and J52-F: BTA3 (PCE = 9.04%). Overall, the research results indicate that subtle structure modification of NFAs, especially introducing fused rings, is a simple and effective strategy to extend the photoelectric response, boosting the  JSC and ensuring a high VOC beyond 1.0 V.

11.
Zookeys ; 1112: 199-218, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36760620

RESUMO

Three new species of the predaceous midges of genus Alluaudomyia Kieffer, 1913: A.flavinotum Wu & Li, sp. nov. of the maculipennis group, and A.reflexuralis Wu & Li, sp. nov. and A.limu Wu & Li, sp. nov. of the parva group, are described from the National Park of Hainan Tropical Rainforest, Hainan Island, China. Illustrations and COI barcodes (a fragment of the mitochondrial cytochrome c oxidase subunit 1) of the three new species are also provided. Associations of male and female specimens of two species (A.reflexuralis Wu & Li, sp. nov. and A.limu Wu & Li, sp. nov.) are supported by DNA barcodes. The parva group is reported from China for the first time.

12.
Asian Pac J Cancer Prev ; 15(5): 2021-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24716928

RESUMO

AIM: Recent research suggests that nucleophosmin (NPM) may be a prognostic marker in colorectal carcinomas (CRC). We here tested its use to predict the survival of CRC patients. METHODS: We investigated NPM expression by immunohistochemistry in histologically normal to malignant colorectal tissues and evaluated its association with clinicopathological variables. Overall and disease-free survival after tumor removal were calculated by the Kaplan-Meier method, and differences in survival curves were analyzed by the log-rank test. The Cox proportional hazards model was used for multivariate analysis of prognostic factors. RESULTS: NPM expression was found significantly upregulated in CRC compared to adjacent colorectal tissue, villous adenoma, tubular adenoma and normal colorectal mucosa (p<0.05 for all). NPM expression was statistically linked to cancer embolus, lymph node metastasis, differentiation grade, and recurrence of CRC. Overall and disease-free survival of NPM-negative CRC patients tended to be better than those for patients with NPM-positive lesions (log-rank statistic, p<0.05 for all). Multivariate analysis indicated NPM expression as an independent prognostic indicator for CRC patients (p<0.05 ). CONCLUSION: Our results suggest that NPM expression can predict the survival of CRC patients. Prognosis of CRC is determined by not only many known prognostic factors but also by NPM expression.


Assuntos
Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Proteínas Nucleares/genética , Biomarcadores Tumorais/genética , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica/métodos , Estimativa de Kaplan-Meier , Metástase Linfática/genética , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Nucleofosmina , Prognóstico , Regulação para Cima/genética
13.
Life Sci ; 85(15-16): 549-56, 2009 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-19747492

RESUMO

Type 1 diabetes (T1D) is the result of the autoimmune response against pancreatic insulin-producing ss-cells. Its ultimate consequence is beta-cell insufficiency-mediated dysregulation of blood glucose control. In terms of T1D treatment, immunotherapy addresses the cause of T1D, mainly through re-setting the balance between autoimmunity and regulatory mechanisms. Regulatory T cells play an important role in this immune intervention. An alternative T1D treatment is beta-cell replacement, which can reverse the consequence of the disease by replacing destroyed beta-cells in the diabetic pancreas. The applicable insulin-producing cells can be directly obtained from islet transplantation or generated from other cell sources such as autologous adult stem cells, embryonic stem cells, and induced pluripotent stem cells. In this review, we summarize the recent research progress and analyze the possible advantages and disadvantages of these two therapeutic options especially focusing on the potential synergistic effect on T1D treatment. Exploring the optimal combination of immunotherapy and beta-cell replacement will pave the way to the most effective cure for this devastating disease.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Imunoterapia/métodos , Células Secretoras de Insulina/transplante , Terapia Combinada , Diabetes Mellitus Tipo 1/imunologia , Humanos
14.
Cell Transplant ; 18(8): 833-45, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19500470

RESUMO

Pancreatic islet transplantation has the potential to be an effective treatment for type 1 diabetes mellitus. While recent improvements have improved 1-year outcomes, follow-up studies show a persistent loss of graft function/survival over 5 years. One possible cause of islet transplant failure is the immunosuppressant regimen required to prevent alloimmune graft rejection. Although there is evidence from separate studies, mostly in rodents and cell lines, that FK506 (tacrolimus), rapamycin (sirolimus), and mycophenolate mofetil (MMF; CellCept) can damage pancreatic beta-cells, there have been few side-by-side, multiparameter comparisons of the effects of these drugs on human islets. In the present study, we show that 24-h exposure to FK506 or MMF impairs glucose-stimulated insulin secretion in human islets. FK506 had acute and direct effects on insulin exocytosis, whereas MMF did not. FK506, but not MMF, impaired human islet graft function in diabetic NOD*scid mice. All of the immunosuppressants tested in vitro increased caspase-3 cleavage and caspase-3 activity, whereas MMF induced ER-stress to the greatest degree. Treating human islets with the GLP-1 agonist exenatide ameliorated the immunosuppressant-induced defects in glucose-stimulated insulin release. Together, our results demonstrate that immunosuppressants impair human beta-cell function and survival, and that these defects can be circumvented to a certain extent with exenatide treatment.


Assuntos
Apoptose/efeitos dos fármacos , Glucose/farmacologia , Insulina/metabolismo , Ilhotas Pancreáticas/efeitos dos fármacos , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/farmacologia , Sirolimo/farmacologia , Tacrolimo/farmacologia , Animais , Células Cultivadas , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 1/terapia , Avaliação Pré-Clínica de Medicamentos , Humanos , Imunossupressores/farmacologia , Secreção de Insulina , Ilhotas Pancreáticas/metabolismo , Transplante das Ilhotas Pancreáticas/métodos , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID
15.
Arch Surg ; 140(8): 735-44, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16103282

RESUMO

HYPOTHESIS: A local multiorgan donor pancreas procurement program can provide a source for optimized isolation of purified viable islets for transplantation into patients with type 1 diabetes mellitus receiving best medical therapy. DESIGN: Prospective before-after cohort study. SETTING: Tertiary referral center. PATIENTS: Glycemic control was assessed in 10 patients with diabetes-induced renal dysfunction who were enrolled in a best medical therapy program and then crossed over to islet transplantation. INTERVENTIONS: Thirty human pancreata were retrieved from local multiorgan donors and consecutively processed with intraductal collagenase perfusion, continuous digestion, and density gradient purification (group 1, n = 9) or similarly processed but impure tissue fractions cultured in vitro and then repurified to retrieve additional islets (group 2, n = 21). Islets were implanted by percutaneous portal embolization, providing more than 10 000 islet equivalents (IE) per kilogram of body weight (infusions from 1-3 donors per patient) under cover of antithymocyte globulin, sirolimus, or mycophenolate mofetil and tacrolimus. MAIN OUTCOME MEASURES: Islet yields, purity, and cell viability (caspase 3, terminal deoxynucleotidyl transferase-mediated biotin-deoxyuridine 5-triphosphate nick-end labeling stain, and insulin secretion in vitro) were compared. In patients, monitored metabolic parameters were C-peptide secretion, insulin requirements, glycemic excursion, and hemoglobin A(1c) (HbA(1c)). RESULTS: For group 1 vs group 2, no differences were observed in pancreas age (43 vs 44 years), cold storage (5 vs 4 hours), or weight (73 vs 82 g). Group 2 yielded 453 690 IE vs 214 109 IE in group 1 (P = .002). Grafts contained 50% or more endocrine cells in both groups. No difference occurred in cell viability or insulin secretion. Islets from 90% of group 2 pancreata met release criteria for transplantation. C-peptide secretion was detected in all recipients and persisted with a median follow-up to 12 months (range, 6-21 months) after full islet transplantation. Daily insulin dependence was reversed in all patients for at least 3 months. Five patients resumed small insulin doses. Compared with the best care program, all patients had improved metabolic stability. The mean +/- SE HbA(1c) level at entry into the study was 7.8% +/- 0.5%, and this decreased to 6.9% +/- 0.2% after best care (P = .38) and further to 6.2% +/- 0.2% at 6 months after transplantation (P = .002 vs entry; P = .15 vs best care; analysis of variance). CONCLUSIONS: Local pancreas donor retrieval with islet isolation and culture conditioning enabled an offer of islets for transplantation for 90% of consecutively processed pancreata. Isolated islets secreted insulin during prolonged follow-up after implantation into patients, yielding metabolic control comparable with that achieved by best medical therapy.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/cirurgia , Insulina/uso terapêutico , Transplante das Ilhotas Pancreáticas/métodos , Ilhotas Pancreáticas/citologia , Imunologia de Transplantes/fisiologia , Adulto , Análise de Variância , Glicemia/análise , Estudos de Coortes , Diabetes Mellitus Tipo 1/diagnóstico , Feminino , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Transplante das Ilhotas Pancreáticas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Probabilidade , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença , Coleta de Tecidos e Órgãos , Resultado do Tratamento
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