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| Author(s): |
Alexandre Sarubbi Raposo do Amaral
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2012-09-25 |
| Examining board members: |
Maria Lucia Cardillo Correa Giannella;
Adriana Ribeiro Leite;
Marisa Passarelli;
Maria Elizabeth Rossi da Silva;
Mari Cleide Sogayar
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| Advisor: | Maria Lucia Cardillo Correa Giannella |
| Abstract | |
The vascular complications related to Diabetes Mellitus are closely linked to hyperglycemia. Patients who develop metabolic instability and progression of microvascular complications despite intensive insulin therapy are candidates to pancreas transplantation. Pancreatic islet transplant is an alternative approach since it is less immunogenic and minimally invasive. However, the success of pancreatic islet transplantation still faces many challenges, mainly related to cell damage during the islet isolation process and early post-transplant period. The increase in reactive oxygen species (ROS) generation and the consumption of antioxidant defenses might be factors related to these injuries. The aim of the present study was to evaluate whether supplementation with glutathione-ethyl-ester (GEE), a compound with higher bioavailability than glutathione (an important endogenous antioxidant), could improve islet viability and efficacy in a marginal islet transplantation model in rodents. GEE was added to a final concentration of 10 mM in collagenase solution during islet isolation. After isolation, in vitro studies were conducted to evaluate the presence of ROS using carboxy-H2DCFDA assay and the viability of isolated islets with JC-1 assay (mitochondrial integrity), Sytogreen/ethidium bromide assay (cellular membrane integrity), fractional beta cell viability assay by flow cytometry, TUNEL assay for apoptosis evaluation and glucose-stimulated insulin secretion. We also performed in vivo studies with islet transplantation under the kidney capsule of diabetic mice, 30 days follow-up after transplantation and recovery of the graft for histological analysis. Four experimental groups were evaluated: 1) animals transplanted with 500 islets, a number considered sufficient to promote diabetes reversion, not isolated in presence of GEE; 2) animals transplanted with 500 islets isolated in presence of GEE; 3) animals transplanted with 150 islets, a number considered insufficient to promote diabetes reversion, not isolated in presence of GEE and 4) animals transplanted with 150 islets isolated in presence of GEE. The addition of GEE at 10 mM concentration during islet isolation was able to decrease ROS content in isolated islets (Control 57.0 ± 4.3% versus GEE 47.0 ± 3.9%, p = 0.0034) and increase islet viability, as demonstrated by the Sytogreen/ethidium bromide assay (Control 70.6 ± 3.4% versus GEE 83.6 ± 4.8%, p = 0.0010) as well as by the reduction in TUNEL-positive cells (Control 39.2 ± 5.0% versus GEE 29.1 ± 1.9%, p = 0.042) in the treated group. The fractional beta-cell viability also showed an improvement in the treated group (Control 21.4 ± 3.4% versus GEE 33.7 ± 3.9%, p = 0.0156). The improved cell viability observed in vitro was translated into better outcomes in vivo, since supplementation of GEE during the isolation process resulted in a significantly lower rate of TUNEL-positive cells (Control 23,3 ± 2,6% versus GEE 8,3 ± 0,8%, p < 0,0001) in the islet grafts recovered after 24h of transplantation and in a higher percentage of normoglycemia (Control 30% versus GEE 65,2%, p = 0,004) after 30 days of follow-up in animals transplanted with the marginal islet mass (150 islets). In conclusion, the current data corroborate that ROS production is a relevant cause of cellular damage during islet isolation and suggest that the use of GEE might be a strategy to improve islet transplantation outcomes (AU) | |