Immunosuppressive therapy in pancreas and islet transplant: Need for simultaneous assessment of insulin sensitivity and secretion

Abstract

Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin action and secretion (using the surrogate indexes) suggesting their use in large studies in populations of pancreas/ islets transplanted patients.

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Benedini, S. , Caumo, A. , Terruzzi, l. and Luzi, L. (2013) Immunosuppressive therapy in pancreas and islet transplant: Need for simultaneous assessment of insulin sensitivity and secretion. Journal of Diabetes Mellitus, 3, 156-160. doi: 10.4236/jdm.2013.33024.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Martel, R.R, Klicius, J. and Galet, S. (1977) Inhibition of the immune response by rapamycin, a new antifungal antibiotic. Canadian Journal of Physiology and Pharmacology, 55, 48-51. doi:10.1139/y77-007
[2] Douros, J. and Suffness, M. (1981) New antitumor substances of natural origin. Cancer Treatment Reviews, 8 63-87. doi:10.1016/S0305-7372(81)80006-0
[3] Dumont, J., Staruch, M.J., Koprak, S.L., et al. (1992) The immunosuppressive and toxic effects of FK-506 are mechanistically related: Pharmacology of a novel antagonist of FK-506 and rapamycinI. The Journal of Experimental Medicine, 176, 51.
[4] Liu, J., Farmer, J.D., Lane, W.S., et al. (1991) Calcineurin is a common target of cyclophilin-cyclosporin A and FKBP-FK506 complexes. Cell, 66, 807-815. doi:10.1016/0092-8674(91)90124-H
[5] MacDonald, A.S. (2003) Rapamycin in combination with cyclosporine or tacrolimus in liver, pancreas, and kidney transplantation. Transplantation Proceedings, 35, 201S-208S. doi:10.1016/S0041-1345(03)00231-8
[6] Perseghin, G., Regalia, E., Battezzati, A., et al. (1997) Regulation of glucose homeostasis in humans with denervated livers. Journal of Clinical Investigation, 100, 931-941. doi:10.1172/JCI119609
[7] Luzi, L., Secchi, A., Facchini, F., et al. (1990) Reduction of insulin resistance by combined kidney-pancreas transplantation in type 1 (insulin-dependent) diabetic patients. Diabetologia, 33, 549-556. doi:10.1007/BF00404143
[8] Gillkinson, S.G., Bartlett, S.T. and Cury, D.L. (1989) Synthesis-secretion coupling of insulin: Effect of cyclosporin. Diabetes, 38, 464-470.
[9] Shapiro, R. (2004) Low toxicity immunosuppressive protocols in renal transplantation. The Keio Journal of Medicine, 53, 18-22. doi:10.2302/kjm.53.18
[10] Luzi, L., Perseghin, G., Brendel, M.D., et al. (2001) Metabolic effects of restoring partial beta-cell function after islet allotransplantation in type 1 diabetic patients. Diabetes, 50, 277-282. doi:10.2337/diabetes.50.2.277
[11] Bretzel, R.G., Browatzki, C.C., Schultz, A., et al. (1993) Clinical islet transplantation in diabetes mellitus (German). Diabetes Stoffwechsel und Herz, 2, 378-390.
[12] Alejandro, R., Mintz, D.H., Noel, J., et al. (1987) Islet cell transplantation in type 1 diabetes mellitus. Transplantation Proceedings, 19, 2359-2361.
[13] London, N.J., Robertson, G.S., Chadwick, D.R., et al. (1994) Human pancreatic islet isolation and transplantation. Clinical Transplantation, 8, 421-459.
[14] Luzi, L., Castellino, P., Simonson, D.C., et al. (1990) Leucine metabolism in insulin-dependent diabetes mellitus: Role of insulin and substrate availability. Diabetes, 39, 38-48. doi:10.2337/diabetes.39.1.38
[15] Luzi, L., Petrides, A.S. and DeFronzo, R.A. (1993) Different sensitivity to insulin of glucose and amino acid metabolism in NIDDM. Diabetes, 42, 1868-1877. doi:10.2337/diabetes.42.12.1868
[16] Luzi, L, Groop, L.C., Perseghin, G, et al. (1996) Effect of pancreas transplantation on free fatty acids metabolism in uremic IDDM patients. Diabetes, 45, 354 -360. doi:10.2337/diabetes.45.3.354
[17] Groop, L.C., Bonadonna, R.C., Del Prato, S., et al. (1989) Glucose and free fatty acids metabolism in non-insulindependent diabetes mellitus: Evidence for multiple sites of insulin resistance. Journal of Clinical Investigation, 84, 205-213. doi:10.1172/JCI114142
[18] Matthews, D.R., Hosker, J.P., Rudenski, A.S., Naylor, B.A., Treacher, D.F. and Turner, R.C. (1985) Homeostasis model assessment: Insulin resistance and ?-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28, 412-419. doi:10.1007/BF00280883
[19] Dallla, M.C, Caumo, A., Basu, R., Rizza, R., Toffolo, G.M. and Cobelli, C. (2004) Minimal model estimation of glucose absorption and insulin sensitivity from oral test: Validation with a tracer method. American Journal of Physiology—Endocrinology and Metabolism, 287, E637-E643. doi:10.1152/ajpendo.00319.2003
[20] Perseghin, G., Hilden, H., Bianchi, E., et al. (1993) Normal sensitivity of FFA metabolism despite resistance of glucose metabolism to insulin after pancreas transplantation. Diabetes, 43, 138a.
[21] Luzi, L., Hering, B.J., Socci, C., et al. (1996) Metabolic effects of successful intraportal islet transplantation in insulin-dependent diabetes mellitus. Journal of Clinical Investigation, 97, 2611-2618. doi:10.1172/JCI118710
[22] Perseghin, G., Caumo, A, Sereni, L.P., et al. (2002) Fasting blood sample-based assessment of insulin sensitivity in kidney-pancreas-transplanted patients. Diabetes Care, 25, 2207-2211. doi:10.2337/diacare.25.12.2207
[23] Song, Y., Manson, J.E., Tinker, L., Howard, B.V., Kuller, L.H., Nathan, L., Rifai, N. and Liu, S. (2007) Insulin sensitivity and insulin secretion determined by homeostasis model assessment and risk of diabetes in a multiethnic cohort of women: The Women’s Health Initiative Observational Study. Diabetes Care, 30, 1747-1752. doi:10.2337/dc07-0358
[24] Del Prato, S., Marchetto, P. and Bonadonna, R.C. (2002) Phasic insulin release and metabolic regulation in type 2 diabetes. Diabetes, 51, S109-S116. doi:10.2337/diabetes.51.2007.S109
[25] Perseghin, G., Caumo, A., Mazzaferro, V., Pulvirenti, A., Piceni, S.L., Romito, R., et al. (2003) Assessment of insulin sensitivity based on a fasting blood sample in men with liver cirrhosis before and after liver transplantation. Transplantation, 76, 697-702. doi:10.1097/01.TP.00000792 52.94857.8D
[26] Wallace, T.M., Levy, J.C. and Mattehews, D.R. (2004) Use and abuse of HOMA modeling. Diabetes Care, 27, 1487-1495. doi:10.2337/diacare.27.6.1487
[27] Cobelli, C., Toffolo, G.M., Dallla, M.C., Campioni, M., Denti, P., Caumo, A., Butler, P.C. and Rizza, R.A. (2007) Assessment of beta cell function in humans, simultaneously with insulin sensitivity and hepatic extraction, from intravenous and oral glucose test. American Journal of Physiology—Endocrinology and Metabolism, 293, E1-E15. doi:10.1152/ajpendo.00421.2006
[28] Cai, W., Hu, L. and Foulkes, J.G. (1996) Transcriptionmodulating drugs: Mechanism and selectivity. Current Opinion in Biotechnology, 7, 608-615. doi:10.1016/S0958-1669(96)80071-1
[29] Fernandez, L.A., Lehmann, R., Luzi, L., et al. (1999) The effects of maintenance doses of FK506 versus cyclosporin A on glucose and lipid metabolism after orthotopic liver transplantation. Transplantation, 68, 1532-1541. doi:10.1097/00007890-199911270-00017
[30] Patti, M.E., Brambilla, E., Luzi, L., et al. (1998) Bidirectional modulation of insulin action by amino acids. Journal of Clinical Investigation, 101, 1519-1529. doi:10.1172/JCI1326
[31] Uwaifo, G.I., Fallon, E.M., Chin, J., Elberg, J., Parikh, S.J. and Yanovski, J.A. (2002) Indices of insulin action, disposal, and secretion derived from fasting samples and clamps in normal glucose-tolerant black and white children. Diabetes Care, 25, 2081-2087. doi:10.2337/diacare.25.11.2081

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