Background: Total pancreatectomy followed by autologous islet transplantation (TP-AIT) is an advanced surgical option for refractory chronic pancreatitis (CP) patients. Peri-transplant inflammatory reaction can damage islet engraftment.
Methods: A total of 10 CP patients with TP-AIT were analyzed. TNFΑ antagonist (etanercept; 25 mg subcutaneous injection on day 0,1,4 and 7) was given to 5 patients (single blockage: [SB] group). Another 5 patients were administered IL-1Β blocker (anakinra; 100 mg S.C. on day 0 to 7) additionally (double blockage [DB] group). There was no significant difference in pre-transplant basic characteristics (Table). Cytokine profiles were evaluated with Luminex assay system using peri-transplant blood samples.
|Variables||Single Blockage group|
|Double Blockage group|
|Sex; Female –n(%)||3 (60%)||3 (60%)||1.0|
|Body mass index (kg/m2)||24.6±2.5||24.4±1.4||0.95|
|Disease duration (year)||7±2||10±5||0.62|
|Fasting C-peptide (ng/mL)||1.6±0.3||1.7±0.4||0.96|
|Total islet yield (×103IEQ)||395±164||369±103||0.89|
|Islet dose (×103IEQ/kg)||5.7±2.1||5.3±1.4||0.88|
Results: No significant adverse events were observed in both groups. Proinsulin levels in early post-AIT was higher in SB group compared to DB group suggesting islet damage (*p <0.05, Figure). TNFΑ levels were mostly similar between the two groups. DB group had lower IL-1Β levels with significant difference at 1 and 3 hr-post IAT when compared to SB group. Proinflammatory cytokines IP-10 and anti-inflammatory IL-10 levels were inversely regulated between two groups during peri-transplant period.
Conclusions: Double blockage of TNFΑ and IL-1Β offers a safe and better protection for islet grafts from inflammatory reaction during peri-transplant period in autologous islet transplantation.
To cite this abstract in AMA style:Naziruddin B, Takita M, Kunnathodi F, Shahbazov R, Kanak M, Lawrence M, Onaca N, Levy M. Double Blockage of TNFα and IL-1β Prevents Islet Graft Damage in Clinical Islet Autotransplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/double-blockage-of-tnf-and-il-1-prevents-islet-graft-damage-in-clinical-islet-autotransplantation/. Accessed December 7, 2019.
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