title: Secretory defects induced by immunosuppressive agents on human pancreatic beta-cells.
abstract: Despite the considerable interest for islet and pancreas transplantation, remarkably little is known about the direct effects of immunosuppressive drugs on human beta-cell function. We measured different insulin secretory parameters and insulin gene expression of human islets cultured for 5 days in the presence of mycophenolate mofetil (MMF), cyclosporin A (CsA), tacrolimus (FK506) or a mixture of 3 cytokines. Basal insulin release after exposure to cytokines and FK506 was significantly higher than in control islets. Responsiveness to an acute glucose stimulus did not differ significantly between control and treated islets. However, absolute incremental insulin responses (delta-AUCs) of islets exposed to cytokines or FK506 were significantly higher compared to islets exposed to CsA or MMF, mainly because of the higher basal release. Indeed, maximal over basal release (stimulation index, SI) tended to be lower in islets exposed to FK506 than in control islets. Insulin gene expression was significantly reduced only in islets exposed to CsA. FK506 was, among those tested, the immunosuppressive drug that most profoundly altered the normal insulin secretory pattern of human beta-cells, whereas CsA was the only inhibiting insulin gene expression. Although the abnormalities induced by the immunosoppressive drugs utilized in this study were modest, these in vitro data are consistent with the reported in vivo diabetogenicity of CsA and FK506 and point to MMF as the ideal immunosuppressive agent from a pancreatic beta-cell point of view.
authors.affiliation: Department of Medicine, San Raffaele Scientific Institute, Via Olgettina 60, I-20132 Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Polastri
authors.forename: F
authors.initials: F
authors.lastname: Galbiati
authors.forename: F
authors.initials: F
authors.lastname: Bertuzzi
authors.forename: P
authors.initials: P
authors.lastname: Fiorina
authors.forename: R
authors.initials: R
authors.lastname: Nano
authors.forename: S
authors.initials: S
authors.lastname: Gregori
authors.forename: L
authors.initials: L
authors.lastname: Aldrighetti
authors.forename: G
authors.initials: G
authors.lastname: Pozza
authors.forename: A
authors.initials: A
authors.lastname: Secchi
authors.forename: L
authors.initials: L
authors.lastname: Adorini
authors.forename: A M
authors.initials: AM
authors.lastname: Davalli
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000494:pharmacology; D015870:Gene Expression / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D066298:In Vitro Techniques; D007328:Insulin / Q000235:genetics / Q000378:metabolism*; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000187:drug effects* / Q000378:metabolism*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000494:pharmacology; D012333:RNA, Messenger / Q000378:metabolism; D016559:Tacrolimus / Q000494:pharmacology
chemical_list: D007166:Immunosuppressive Agents; D007328:Insulin; D012333:RNA, Messenger; D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus