Induction, management, and complications of streptozotocin-induced diabetes mellitus in rhesus monkeys.
Diabetes mellitus (DM) model using streptozotocin (STZ) which induces chemical ablation of β cell in the pancreas has been widely used for various research purposes in non-human primates. However, STZ has been known to have a variety of adverse effects such as nephrotoxicity, hepatotoxicity, and even mortality. The purpose of this study is to report DM induction by STZ, toxicity associated with STZ and procedure and complication of exogenous insulin treatment for DM management in rhesus monkeys (Macaca mulatta) that are expected to be transplanted with porcine islets within 2 months.



Streptozotocin (immediately dissolved in normal saline, 110 mg/kg) was slowly infused via central catheter for 10 minutes in 22 rhesus monkeys. Clinical signs, complete blood count and blood chemistry were monitored to evaluate toxicity for 1 week after STZ injection. Monkey basal C-peptides were measured and intravenous glucose tolerance test was performed to confirm complete induction of DM. Exogenous insulin was subcutaneously injected to maintain blood glucose in diabetic rhesus monkeys and the complications were recorded while in insulin treatment.



Severe salivation and vomiting were observed within 1 hour after STZ injection in 22 rhesus monkeys. One monkey died at 6 hours after STZ injection and the reason for the death was unknown. Pancreatitis was noticed in one monkey after STZ injection, but the monkey recovered after 5 days by medical treatment. Serum total protein and albumin decreased whereas the parameters for the liver function such as aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase significantly increased (P<.05) after STZ injection, but they were resolved within 1 week. Azotemia was not observed. Monkey fasting C-peptide levels after STZ injection were <0.1 ng/mL in 18 rhesus monkeys, but 0.34, 0.22, 0.16 ng/mL in three monkeys, respectively. The value of daily insulin requirement was 0.92±0.26IU/kg/d (range=0.45-1.29) in the monkeys. Diabetic ketoacidosis was observed in one rhesus monkeys, but the monkey recovered after 24 hours by fluid and insulin treatment.



Streptozotocin was effective for inducing DM in rhesus monkeys, but various adverse effects such as pancreatitis, liver toxicity or death were observed. Therefore, careful and suitable medical managements should be implemented to eliminate the risks of mortality and severe adverse effects.
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Jong-Min
JM
Kim
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea.
Jun-Seop
JS
Shin
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea.
Byoung-Hoon
BH
Min
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea.|Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.
Hyun-Je
HJ
Kim
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea.
Jung-Sik
JS
Kim
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea.
Il-Hee
IH
Yoon
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.
Won-Young
WY
Jeong
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.
Ga-Eul
GE
Lee
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.
Min-Sun
MS
Kim
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.
Ju-Eun
JE
Kim
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sang-Man
SM
Jin
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea.|Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.
Chung-Gyu
CG
Park
D000818:Animals; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003921:Diabetes Mellitus, Experimental / Q000139:chemically induced / Q000628:therapy*; D007328:Insulin / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008253:Macaca mulatta; D008297:Male; D010179:Pancreas / Q000187:drug effects / Q000378:metabolism; D016035:Pancreas Transplantation; D013311:Streptozocin; D014183:Transplantation, Heterologous / Q000379:methods
D001786:Blood Glucose; D007328:Insulin; D013311:Streptozocin
diabetes mellitus; diabetic ketoacidosis; insulin dose; rhesus monkey; streptozotocin