Oxygen environment and islet size are the primary limiting factors of isolated pancreatic islet survival

Background: Type 1 diabetes is an autoimmune disease that destroys insulin-producing beta cells in the pancreas. Pancreatic islet transplantation could be an effective treatment option for type 1 diabetes once several issues are resolved, including donor shortage, prevention of islet necrosis and loss in pre- and post-transplantation, and optimization of immunosuppression. This study seeks to determine the cause of necrotic loss of isolated islets to improve transplant efficiency. Methodology: The oxygen tension inside isolated human islets of different sizes was simulated under varying oxygen environments using a computational in silico model. In vitro human islet viability was also assessed after culturing in different oxygen conditions. Correlation between simulation data and experimentally measured islet viability was examined. Using these in vitro viability data of human islets, the effect of islet diameter and oxygen tension of the culture environment on islet viability was also analyzed using a logistic regression model. Principal findings: Computational simulation clearly revealed the oxygen gradient inside the islet structure. We found that oxygen tension in the islet core was greatly lower (hypoxic) than that on the islet surface due to the oxygen consumption by the cells. The hypoxic core was expanded in the larger islets or in lower oxygen cultures. These findings were consistent with results from in vitro islet viability assays that measured central necrosis in the islet core, indicating that hypoxia is one of the major causes of central necrosis. The logistic regression analysis revealed a negative effect of large islet and low oxygen culture on islet survival. Conclusions/Significance: Hypoxic core conditions, induced by the oxygen gradient inside islets, contribute to the development of central necrosis of human isolated islets. Supplying sufficient oxygen during culture could be an effective and reasonable method to maintain isolated islets viable

Oxygen environment and islet size are the primary limiting factors of isolated pancreatic islet survival

Background: Type 1 diabetes is an autoimmune disease that destroys insulin-producing beta cells in the pancreas. Pancreatic islet transplantation could be an effective treatment option for type 1 diabetes once several issues are resolved, including donor shortage, prevention of islet necrosis and loss in pre- and post-transplantation, and optimization of immunosuppression. This study seeks to determine the cause of necrotic loss of isolated islets to improve transplant efficiency. Methodology: The oxygen tension inside isolated human islets of different sizes was simulated under varying oxygen environments using a computational in silico model. In vitro human islet viability was also assessed after culturing in different oxygen conditions. Correlation between simulation data and experimentally measured islet viability was examined. Using these in vitro viability data of human islets, the effect of islet diameter and oxygen tension of the culture environment on islet viability was also analyzed using a logistic regression model. Principal findings: Computational simulation clearly revealed the oxygen gradient inside the islet structure. We found that oxygen tension in the islet core was greatly lower (hypoxic) than that on the islet surface due to the oxygen consumption by the cells. The hypoxic core was expanded in the larger islets or in lower oxygen cultures. These findings were consistent with results from in vitro islet viability assays that measured central necrosis in the islet core, indicating that hypoxia is one of the major causes of central necrosis. The logistic regression analysis revealed a negative effect of large islet and low oxygen culture on islet survival. Conclusions/Significance: Hypoxic core conditions, induced by the oxygen gradient inside islets, contribute to the development of central necrosis of human isolated islets. Supplying sufficient oxygen during culture could be an effective and reasonable method to maintain isolated islets viable

Isolated human islets require hyperoxia to maintain islet mass, metabolism, and function

Pancreatic islet transplantation has been recognized as an effective treatment for Type 1 diabetes; however, there is still plenty of room to improve transplantation efficiency. Because islets are metabolically active they require high oxygen to survive; thus hypoxia after transplant is one of the major causes of graft failure. Knowing the optimal oxygen tension for isolated islets would allow a transplant team to provide the best oxygen environment during pre- and post-transplant periods. To address this issue and begin to establish empirically determined guidelines for islet maintenance, we exposed in vitro cultured islets to different partial oxygen pressures (pO_2) and assessed changes in islet volume, viability, metabolism, and function. Human islets were cultured for 7 days in different pO_2 media corresponding to hypoxia (90 mmHg), normoxia (160 mmHg), and hyerpoxia (270 or 350 mmHg). Compared to normoxia and hypoxia, hyperoxia alleviated the loss of islet volume, maintaining higher islet viability and metabolism as measured by oxygen consumption and glucose-stimulated insulin secretion responses. We predict that maintaining pre- and post-transplanted islets in a hyperoxic environment will alleviate islet volume loss and maintain islet quality thereby improving transplant outcomes

Insulin Gene Expression Is Regulated by DNA Methylation

BACKGROUND:Insulin is a critical component of metabolic control, and as such, insulin gene expression has been the focus of extensive study. DNA sequences that regulate transcription of the insulin gene and the majority of regulatory factors have already been identified. However, only recently have other components of insulin gene expression been investigated, and in this study we examine the role of DNA methylation in the regulation of mouse and human insulin gene expression. METHODOLOGY/PRINCIPAL FINDINGS:Genomic DNA samples from several tissues were bisulfite-treated and sequenced which revealed that cytosine-guanosine dinucleotide (CpG) sites in both the mouse Ins2 and human INS promoters are uniquely demethylated in insulin-producing pancreatic beta cells. Methylation of these CpG sites suppressed insulin promoter-driven reporter gene activity by almost 90% and specific methylation of the CpG site in the cAMP responsive element (CRE) in the promoter alone suppressed insulin promoter activity by 50%. Methylation did not directly inhibit factor binding to the CRE in vitro, but inhibited ATF2 and CREB binding in vivo and conversely increased the binding of methyl CpG binding protein 2 (MeCP2). Examination of the Ins2 gene in mouse embryonic stem cell cultures revealed that it is fully methylated and becomes demethylated as the cells differentiate into insulin-expressing cells in vitro. CONCLUSIONS/SIGNIFICANCE:Our findings suggest that insulin promoter CpG demethylation may play a crucial role in beta cell maturation and tissue-specific insulin gene expression

Pertuzumab for the treatment of ovarian cancer

Importance of the field: Pertuzumab is a humanized monoclonal antibody that inhibits human epidermal growth factor receptor 2 (HER2) heterodimerization and has demonstrated clinical activity against both breast and ovarian cancer. To date, it is the most extensively studied HER2 inhibitor in ovarian cancer.Areas covered in this review: We focus on the published descriptions of preclinical and clinical activity in ovarian cancer and biomarkers associated with response. We compare the activity of pertuzumab with that of other clinically evaluated HER2 inhibitors.What the reader will gain: To date, pertuzumab is the most extensively trialled HER2 inhibitor in ovarian cancer, with almost 400 patients having been treated in three large Phase II studies. Recent clinical trials data indicate that pertuzumab enhances gemcitabine's activity in platinum-resistant ovarian cancer and may enhance carboplatin's activity in platinum-sensitive disease; moreover the subgroup who benefit from pertuzumab appear to be those with cancers with activated HER2 or low HER3 mRNA expression. This review examines the recent clinical trials results and associated preclinical studies that support the utility of pertuzumab in this disease.Take home message: Pertuzumab may have value for the treatment of ovarian cancer. Further prospective biomarker-led trials are warranted.</p

MEMS Silicon Cutters for Rapid Sectioning of Diffusion-Limited Pancreatic Islets to Improve Viability

This paper reports on the first MEMS silicon cutters designed to rapidly section donor pancreatic islets below oxygen diffusion-limited dimensions to improve viability of grafts during the critical period of re-implantation and revascularization by the host. The monolithic silicon chips feature an array of spaced nano-sharp (r < 100 nm) blades that cleanly section islet tissue. This work represents the first time that sectioning of pancreatic islets has been proposed and validated as a means to overcome the well-known problems of hypoxia and core-necrosis that is encountered in current islet transplantation procedures

MEMS Silicon Cutters for Rapid Sectioning of Diffusion-Limited Pancreatic Islets to Improve Viability

This paper reports on the first MEMS silicon cutters designed to rapidly section donor pancreatic islets below oxygen diffusion-limited dimensions to improve viability of grafts during the critical period of re-implantation and revascularization by the host. The monolithic silicon chips feature an array of spaced nano-sharp (r < 100 nm) blades that cleanly section islet tissue. This work represents the first time that sectioning of pancreatic islets has been proposed and validated as a means to overcome the well-known problems of hypoxia and core-necrosis that is encountered in current islet transplantation procedures