title: Prolonged allogeneic islet graft survival by protoporphyrins.
abstract: Transplantation of islets of Langerhans in patients with type 1 diabetes allows for improved metabolic control and insulin independence. The need for chronic immunosuppression limits this procedure to selected patients with brittle diabetes. Definition of therapeutic strategies allowing permanent engraftment without the need for chronic immunosuppression could overcome such limitations. We tested the effect of the use of protoporphyrins (CoPP and FePP), powerful inducers of the cytoprotective protein heme-oxygenase 1 (HO-1), on allogeneic islet graft survival. Chemically induced diabetic C57BL/6 mice received DBA/2 islets. Treatment consisted in peritransplant administration of CoPP or saline. Islets were either cultured in the presence of FePP or vehicle before implant. Short-course administration of CoPP led to long-term islet allograft survival in a sizable proportion of recipients. Long-term graft-bearing animals rejected third-party islets while accepting a second set donor-specific graft permanently, without additional treatment. Preconditioning of islets with FePP by itself led to improved graft survival in untreated recipients, and provided additional advantage in CoPP-treated recipients, resulting in an increased proportion of long-term surviving grafts. Preconditioning of the graft with protoporphyrins prior to implant resulted in reduction of class II expression. Administration of protoporphyrins to the recipients of allogeneic islets also resulted in transient powerful immunosuppression with reduced lymphocyte proliferative responses, increased proportion of regulatory cells (CD4+CD25+), decreased mononuclear cell infiltrating the graft, paralleled by a systemic upregulation of HO-1 expression. All these mechanisms may have contributed to the induction of donor-specific hyporesponsiveness in a proportion of the protoporphyrin-treated animals.
authors.affiliation: Cell Transplant Center, Diabetes Research Institute, University of Miami School of Medicine, 1450 NW 10th Avenue (R-134), Miami, FL 33136, USA.
authors.forename: Antonello
authors.initials: A
authors.lastname: Pileggi
authors.forename: R Damaris
authors.initials: RD
authors.lastname: Molano
authors.forename: Thierry
authors.initials: T
authors.lastname: Berney
authors.forename: Hirohito
authors.initials: H
authors.lastname: Ichii
authors.forename: Sergio
authors.initials: S
authors.lastname: San Jose
authors.forename: Elsie
authors.initials: E
authors.lastname: Zahr
authors.forename: Raffaella
authors.initials: R
authors.lastname: Poggioli
authors.forename: Elina
authors.initials: E
authors.lastname: Linetsky
authors.forename: Camillo
authors.initials: C
authors.lastname: Ricordi
authors.forename: Luca
authors.initials: L
authors.lastname: Inverardi
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007515:Islets of Langerhans / Q000166:cytology; D016381:Islets of Langerhans Transplantation; D051379:Mice; D011524:Protoporphyrins / Q000494:pharmacology*; D014184:Transplantation, Homologous; D019737:Transplants
chemical_list: D011524:Protoporphyrins