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Inhibition of Thrombin Abrogates the Instant Blood-Mediated Inflammatory Reaction Triggered by Isolated Human Islets: Possible application of the thrombin inhibitor melagatran in clinical islet transplantation
Rudbeck Laboratory, University Hospital, Uppsala.
University of Kalmar, School of Pure and Applied Natural Sciences. Rudbeck Laboratory, University Hospital, Uppsala.ORCID iD: 0000-0001-7888-1571
Rudbeck Laboratory, University Hospital, Uppsala.
Rudbeck Laboratory, University Hospital, Uppsala.
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2002 (English)In: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 51, no 6, p. 1779-1784Article in journal (Refereed) Published
Abstract [en]

A thrombotic/inflammatory reaction is elicited when isolated islets of Langerhans come in contact with ABO-compatible blood. The detrimental effects of this instant blood-mediated inflammatory reaction (IBMIR) provide a reasonable explanation for the observation that an unexpectedly high number of islets, from several donors, are needed to produce normoglycemia in transplant patients with type 1 diabetes. In this study, the hypothesis that a specific thrombin inhibitor, Melagatran, could reduce IBMIR in an in vitro model in which human islets are exposed to ABO-compatible blood was tested. The administration of Melagatran abrogated IBMIR dose-dependently. Islets exposed to blood, in the absence or presence of 0.4 μmol/l Melagatran, exhibited a loss of integrity and were found to be trapped in macroscopic clots containing platelets and CD11b+ leukocytes. At concentrations from 1 to 10 μmol/l, Melagatran inhibited both coagulation and complement activation. Also, platelet and leukocyte activation and consumption were decreased. Islet morphology was maintained with almost no platelets adhering to the surface, and infiltration by CD11b+ leukocytes was considerably reduced. In conclusion, Melagatran significantly reduced IBMIR in this model system. This protective effect indicates that thrombin plays a pivotal role in IBMIR and suggests that thrombin inhibition can improve the outcome of clinical islet transplantation.

Place, publisher, year, edition, pages
2002. Vol. 51, no 6, p. 1779-1784
National Category
Immunology in the medical area
Research subject
Biomedical Sciences, Immunology
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URN: urn:nbn:se:lnu:diva-1149DOI: 10.2337/diabetes.51.6.1779OAI: oai:DiVA.org:lnu-1149DiVA, id: diva2:307938
Available from: 2010-04-01 Created: 2010-04-01 Last updated: 2018-01-12Bibliographically approved

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Nilsson Ekdahl, Kristina

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