Syngeneic transplantation of rat islets into subcutaneous tissue failed to cure streptozocin diabetes. The reason is unknown, but poor vascularization may play a role. We hypothesize that if a well-vascularized subcutaneous site could be created, islet grafts would do well. Four hundred freshly isolated mouse islets were transplanted syngeneically under the renal capsule or into the intraperitoneal cavity and compared with 800 islets in subcutaneous tissue of streptozocin-diabetic mice. Four weeks after transplantation, 14 of 14 under the renal capsule, 4 of 8 in the intraperitoneal site, and 0 of 7 in the subcutaneous tissue site achieved normoglycemia. To create vascularized organoids, we transplanted 800 mouse islets into polyvinyl alcohol (PVA) or polyglycolic acid (PGA) polymers in subcutaneous tissue of streptozocin-diabetic mice either immediately (four in PVA and six in PGA) or 7 days (four in PVA and four in PGA) after implantation. Four weeks after transplantation, the mean blood glucose level and body weight had no change with PVA. However, the mean body weight increased significantly with PGA and 3/10 became normoglycemic. When transplanting 400 islets with PGA polymers intraperitoneally, all animals (n=5) remained hyperglycemic 3 months later. In contrast, four of five recipients transplanted with 800 islets with PGA polymers subcutaneously became normoglycemic. The grafts from successful animals contained numerous revascularized islets containing a substantial amount of insulin. These preliminary results indicate that subcutaneous islet transplantation using PGA polymers can improve the metabolic status and, in some cases, even cure diabetes in streptozocin-diabetic mice.

Leptin is an adipocyte-derived hormone that regulates a number of physiological functions, including energy homeostasis and immune function. In immune responses, leptin plays a role in the induction of inflammation. We investigated a role of leptin in Listeria monocytogenes infection using leptin receptor-deficient db/db mice and leptin-deficient ob/ob mice. These mutant mice were highly susceptible to L. monocytogenes, and the elimination of bacteria from the liver was inhibited. After infection, the induction of monocyte chemoattractant protein-1 (MCP-1) and KC mRNA in the liver of db/db mice and the MCP-1 mRNA expression in the liver of ob/ob mice was decreased compared with their heterozygote littermates. Leptin replacement in ob/ob mice resulted in improvement of anti-listerial resistance and the MCP-1 mRNA expression. The elimination of L. monocytogenes was significantly enhanced, and the expression of MCP-1 and KC mRNA was completely reversed in db/db mice by insulin treatment. These results suggest that leptin is required for host resistance to L. monocytogenes infection and that hyperglycemia caused by leptin deficiency is involved in the inefficient elimination of bacteria from the liver. Moreover, defect of MCP-1 expression in the liver may be involved in the attenuated host resistance in these mutant mice. Diabetes 54:182-189, 2005 L eptin is a small peptide hormone secreted primarily by the adipocyte. Leptin-deficient ob/ob mice (1,2) and receptor-deficient db/db mice (3) were characterized initially as diabetes-obesity syndromes (4). Moreover, these animals exhibit a severe dysregulation of reproductive and hormonal traits (5) as well as a disturbance of hematopoietic and immune functions (6).Lord et al. (7) first reported that leptin increases Thelper (Th)1 cytokine production and suppresses Th2 cytokine production. Implication of leptin in inflammatory responses, including experimental autoimmune encephalomyelitis (8) and experimental arthritis (9), was demonstrated. On the other hand, a recent study showed that neutrophils express leptin receptors and that leptin enhances oxidative species production by neutrophils (10). Moreover, ob/ob mice exhibit impaired host resistance to intratracheal gram-negative Klebsiella pneumoiae infection due to impaired alveolar macrophage phagocytosis and neutrophil complement-mediated phagocytosis (11,12).Diabetes is often identified as an independent risk factor for infections (13,14). We were interested in investigating the role of leptin and its correlation to host resistance to Listeria monocytogenes infection. L. monocytogenes is an intracellular-growing bacterium that is ordinarily nonpathogenic to healthy people; however, it is important as an opportunistic pathogen. The individuals at highest risk are pregnant women and their fetuses, new born infants, debilitated elderly people, and immunocompromized hosts including patients with diabetes (15). Host resistance to L. monocytogenes is controlled by cell-mediated immunity and regulated endogenous cytokines....

Well-characterized aliquots of adult porcine and rat islets of comparable beta-cell mass were transplanted under the kidney capsule of streptozotocin-induced diabetic nude mice. In both porcine and rat islet grafts, beta-cell mass decreased significantly in the first 2 months and stabilized thereafter. As with beta-cell mass, insulin content decreased significantly in the first 2 months to almost 40% of that originally implanted. In porcine grafts, however, insulin content at 4 months was significantly higher than at 2 months. The endocrine non-beta-cell mass of grafts also decreased significantly after transplantation: in porcine grafts, the decrease was less than in rat and was limited to the first 2 months. beta-cell replication of engrafted islets was significantly lower in porcine than in rat grafts. Although beta-cell mass of porcine and rat grafts was similar at all time periods, recipients of porcine islets required a significantly longer time to reach normal glucose levels; nonetheless, their blood glucose levels continued to decrease and stabilized at levels significantly lower than those of normal mice. During oral and intraperitoneal glucose tolerance tests, blood glucose increased only slightly in both the recipients of porcine and rat grafts. When graft-bearing kidneys were perfused in situ, porcine islet grafts showed a 20-fold increase in insulin release in response to both glucose and arginine. In conclusion, this evidence that adult porcine islet grafts can bring glucose levels to those that are normal for humans provides further support of their potential for human islet replacement therapy.