title: A novel resting strategy for improving islet engraftment in the liver.
abstract: BACKGROUND
  Several studies have revealed that posttransplant insulin treatment is beneficial to rest the islet grafts. However, insulin infusion per se is not enough to completely suppress the heavy workload arising caused by postprandial hyperglycemia. Therefore, the present study examined whether short-term fasting combined with insulin treatment could effectively prevent graft exhaustion after intraportal islet transplantation.
  
  
  METHODS
  A marginal dose of syngeneic rat islet grafts were transplanted intraportally into the control, insulin-treated, and insulin+rest groups of streptozotocin-induced diabetic rats. The control group fed freely without insulin treatment, and the other groups were continuously treated with an optimal amount of insulin to maintain normoglycemia. In addition, the insulin+rest group fasted and received total parenteral nutrition during the 2 weeks after transplantation.
  
  
  RESULTS
  The curative rate was significantly higher in both the insulin and insulin+rest groups than the control group (P<0.0001). The glucose tolerance, residual graft mass, and graft function were significantly ameliorated in the insulin+rest group, but not in the insulin group, compared to the control group (P<0.01, P=0.03, P=0.001).
  
  
  CONCLUSIONS
  These data suggest that short-term fasting combined with insulin treatment, especially during the avascular period of the grafts, could therefore be a promising regimen for improving pancreatic islet engraftment in the liver.
authors.affiliation: 1 Division of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan. 2 New Industry Creation Hatchery Center, Tohoku University, Sendai, Japan. 3 Department of Pathology, Tohoku University School of Medicine, Sendai, Japan. 4 Division of Diabetes & Metabolism, Hyogo College of Medicine, Nishinomiya, Japan. 5 Address correspondence to: Masafumi Goto, M.D., Ph.D., New Industry Creation Hatchery Center, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Jimbo
authors.forename: Akiko
authors.initials: A
authors.lastname: Inagaki
authors.forename: Takehiro
authors.initials: T
authors.lastname: Imura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Keisei
authors.initials: K
authors.lastname: Fujimori
authors.forename: Jun-ichiro
authors.initials: J
authors.lastname: Miyagawa
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Satomi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Goto
mesh_terms: D000818:Animals; D017209:Apoptosis; D001786:Blood Glucose / Q000032:analysis; D003921:Diabetes Mellitus, Experimental / Q000628:therapy; D005508:Food Deprivation; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D005951:Glucose Tolerance Test; D006943:Hyperglycemia / Q000188:drug therapy; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D007275:Injections, Intravenous; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use; D007515:Islets of Langerhans; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008099:Liver / Q000378:metabolism*; D008297:Male; D018384:Oxidative Stress; D051381:Rats; D011917:Rats, Inbred Lew
chemical_list: D001786:Blood Glucose; D007328:Insulin; D052216:Glucagon-Like Peptide 1