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Published online December 10, 2007
Diabetes Care 31:436-438, 2008
DOI: 10.2337/dc07-1831
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Metabolic and Immunological Features of the Failing Islet-Transplanted Patient

Paolo Fiorina, MD, PHD1,2, Andrea Vergani, MD1,2, Alessandra Petrelli, MD1, Francesca D'Addio, MD2, Lucilla Monti, MD1, Reza Abdi, MD2, Emanuele Bosi, MD1, Paola Maffi, MD1 and Antonio Secchi, MD1,3

1 Department of Medicine, San Raffaele Scientific Institute, Milan, Italy
2 Transplantation Research, Children's Hospital/Brigham and Women's Hospital, Boston, Massachusetts
3 Università Vita e Salute-San Raffaele, Milan, Italy

Address correspondence and reprint requests to Antonio Secchi, MD, Medicine San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy. E-mail: antonio.secchi{at}hsr.it

OBJECTIVE—This retrospective study was designed to identify metabolic and immune predictors of early islet allograft failure.

RESEARCH DESIGN AND METHODS—We measured several metabolic and immunological markers at the time of pretransplant and several time points posttransplantation in 17 patients with long-term functioning graft (long fx) and 20 patients with short-term functioning graft (short fx).

RESULTS—The short fx group showed higher insulin resistance, altered proinsulin processing, lower soluble interleukin-2 receptor (sIL-2r) (marker of T-cell activation), and higher soluble FasL (marker of apoptosis) during the entire follow-up, particularly at time of failure.

CONCLUSIONS—Patients who experienced an early failure of islet allograft showed specific metabolic and immunological signs long before islet failure.

Abbreviations: HOMA-IR, homeostasis model assessment of insulin resistance • long fx, long-term functioning graft • sFasL, soluble FasL • short fx, short-term functioning graft • sIL-2r, soluble interleukin-2 receptor


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