Activation of the innate immune system in obesity is a risk factor for the development of type 2 diabetes. The aim of the current study was to investigate the notion that increased numbers of macrophages exist in the islets of type 2 diabetes patients and that this may be explained by a dysregulation of islet-derived inflammatory factors. Increased islet-associated immune cells were observed in human type 2 diabetic patients, high-fat-fed C57BL/6J mice, the GK rat, and the db/db mouse. When cultured islets were exposed to a type 2 diabetic milieu or when islets were isolated from high-fat-fed mice, increased isletderived inflammatory factors were produced and released, including interleukin (IL)-6, IL-8, chemokine KC, granulocyte colony-stimulating factor, and macrophage inflammatory protein 1␣. The specificity of this response was investigated by direct comparison to nonislet pancreatic tissue and ␤-cell lines and was not mimicked by the induction of islet cell death. Further, this inflammatory response was found to be biologically functional, as conditioned medium from human islets exposed to a type 2 diabetic milieu could induce increased migration of monocytes and neutrophils. This migration was blocked by IL-8 neutralization, and IL-8 was localized to the human pancreatic ␣-cell. Therefore, islet-derived inflammatory factors are regulated by a type 2 diabetic milieu and may contribute to the macrophage infiltration of pancreatic islets that we observe in type 2 diabetes. Diabetes 56:2356-2370, 2007 A ctivation of the innate immune system has long been reported in obesity, insulin resistance, and type 2 diabetics and is characterized by increased circulating levels of acute-phase proteins and of cytokines and chemokines (1-5). However, the notion that excess circulating nutrients may stimulate the ␤-cell to produce chemokines remains unexplored, and immune cell infiltration has not been shown in islets of type 2 diabetic patients.One of the most classical chemotactic agents in immunology is the CXC family chemokine, interleukin (IL)-8 (CXCL8) (6). IL-8 is produced by leukocytes, fibroblasts, and endothelial and epithelial cells and is commonly associated with infections, graft rejection, allergy, asthma, cancer, and atherosclerosis. In addition to its effect on neutrophils, the chemotactic effect of IL-8 also is important in mediating monocyte migration (7-9). The rodent does not express IL-8. Instead, the rodent functional homolog of IL-8 is thought to be chemokine KC (CXCL1, or Gro-␣ in the rat), which also has been reported to induce granulocyte and monocyte migration (9). Chemokine KC is thought to be an ortholog of human CXCL1. Circulating levels of IL-8 are elevated in type 2 diabetic individuals (10,11), in whom IL-8 has been implicated in systemic insulin resistance and atherosclerosis (12,13).Thus, we hypothesized that pancreatic islets in type 2 diabetes are characterized by increased macrophage infiltration and that a type 2 diabetic milieu could promote chemokine production in pancreatic islets. ...

Recent studies suggest an inflammatory process, characterized by local cytokine/chemokine production and immune cell infiltration, regulates islet dysfunction and insulin resistance in type 2 diabetes. However, the factor initiating this inflammatory response is not known. Here, we characterized tissue inflammation in the type 2 diabetic GK rat with a focus on the pancreatic islet and investigated a role for IL-1. GK rat islets, previously characterized by increased macrophage infiltration, displayed increased expression of several inflammatory markers including IL-1␤. In the periphery, increased expression of IL-1␤ was observed primarily in the liver. Specific blockade of IL-1 activity by the IL-1 receptor antagonist (IL-1Ra) reduced the release of inflammatory cytokines/chemokines from GK islets in vitro and from mouse islets exposed to metabolic stress. Islets from mice deficient in IL-1␤ or MyD88 challenged with glucose and palmitate in vitro also produced significantly less IL-6 and chemokines. In vivo, treatment of GK rats with IL-1Ra decreased hyperglycemia, reduced the proinsulin/insulin ratio, and improved insulin sensitivity. In addition, islet-derived proinflammatory cytokines/chemokines (IL-1␤, IL-6, TNF␣, KC, MCP-1, and MIP-1␣) and islet CD68 ؉ , MHC II ؉ , and CD53 ؉ immune cell infiltration were reduced by IL-1Ra treatment. Treated GK rats also exhibited fewer markers of inflammation in the liver. We conclude that elevated islet IL-1␤ activity in the GK rat promotes cytokine and chemokine expression, leading to the recruitment of innate immune cells. Rather than being directly cytotoxic, IL-1␤ may drive tissue inflammation that impacts on both ␤ cell functional mass and insulin sensitivity in type 2 diabetes.interleukin-1 ͉ metabolic stress ͉ pancreatic islet ͉ insulin resistance ͉ beta cells

The molecular pathways leading to islet fibrosis in diabetes are unknown. Therefore, we studied gene expression in islets of 4-month-old Goto-Kakizaki (GK) and Wistar control rats. Of 71 genes found to be overexpressed in GK islets, 24% belong to extracellular matrix (ECM)/cell adhesion and 34% to inflammatory/immune response families. Based on gene data, we selected several antibodies to study fibrosis development during progression of hyperglycemia by immunohistochemistry. One-month-old GK and Wistar islets appeared to be similar. Two-month-old GK islets were strongly heterogenous in terms of ECM accumulation compared with Wistar islets. GK islet vascularization, labeled by von Willebrand factor, was altered after 1 month of mild hyperglycemia. Numerous macrophages (major histocompatibility complex class II ؉ and CD68 ؉ ) and granulocytes were found in/around GK islets. These data demonstrate that marked inflammatory reaction accompanies GK islet fibrosis and suggest that islet alterations in this nonobese model of type 2 diabetes develop in a way reminiscent of microangiopathy. Diabetes 55: [1625][1626][1627][1628][1629][1630][1631][1632][1633] 2006