Abstract

Pancreatic islet transplantation is a promising therapeutic approach for Type 1 diabetes. A major prerequisite for the survival of grafted islets is a rapid revascularization after transplantation. Erythropoietin (EPO), the primary regulator of erythropoiesis, has been shown to promote angiogenesis. Therefore, we investigated in this study whether EPO improves the revascularization of transplanted islets. Islets from FVB/N mice were transplanted into dorsal skinfold chambers of recipient animals, which were daily treated with an intraperitoneal injection of EPO (500 IU·kg-1 ) or vehicle (control) throughout an observation period of 14 days. In a second set of experiments, animals were only pretreated with EPO over a 6-day period prior to islet transplantation. The revascularization of the grafts was assessed by repetitive intravital fluorescence microscopy and immunohistochemistry. In addition, a streptozotocin-induced diabetic mouse model was used to study the effect of EPO-pretreatment on the endocrine function of the grafts. EPO treatment slightly accelerated the revascularization of the islet grafts. This effect was markedly more pronounced in EPO-pretreated animals, resulting in significantly higher numbers of engrafted islets and an improved perfusion of endocrine tissue without affecting systemic haematocrit levels when compared with controls. Moreover, EPO-pretreatment significantly accelerated the recovery of normoglycaemia in diabetic mice after islet transplantation. These findings demonstrate that, particularly, short-term EPO-pretreatment represents a promising therapeutic approach to improve the outcome of islet transplantation, without an increased risk of thromboembolic events.

Highlights

  • Islet transplantation is a promising strategy for the curative treatment of Type 1 diabetes mellitus (McCall & Shapiro, 2012)

  • The aim of the present study was to analyse the effects of EPO on the revascularization of transplanted pancreatic islets

  • Our results demonstrated that EPO accelerated the revascularization of transplanted islets, resulting in an increased take rate of the grafts and an improved perfusion of the endocrine tissue

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Summary

| INTRODUCTION

Islet transplantation is a promising strategy for the curative treatment of Type 1 diabetes mellitus (McCall & Shapiro, 2012). Only 50–70% of patients remain insulin-independent at 5 years after transplantation (Shapiro, Pokrywczynska, & Ricordi, 2017) This can be explained by the fact that the procedure is still hampered by the inefficiency of the islet isolation process and a low rate of successfully engrafted islets (Ahearn, Parekh, & Posselt, 2015). EPO reduces pancreatic β-cell damage by promoting anti-oxidative processes (Chen et al, 2015; Choi et al, 2010), and EPO decreases blood glucose levels in diabetic mouse models (Katz et al, 2010). Based on these findings, we hypothesized that EPO would accelerate the revascularization and improve the engraftment of freely transplanted pancreatic islets. What is the clinical significance Pretreatment with erythropoietin represents a promising pharmacological approach to improve the outcome of islet transplantation

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Findings
| DISCUSSION
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