Fp852skin Age Deposits Decrease One Year After Pancreas-Kidney Transplantation

Abstract

Introduction and Aims: AGE accumulation in diabetic patients has been proposed as (an) one of the most important mechanisms leading to micro and macrovascular complications. Pancreas-kidney transplantation (PKT), reverting uremia and hyperglycemia may result in AGE reduction or removal, but it is still unknown. We conducted a prospective study in 15 patients, undergoing PKT to analyze AGE evolution after the procedure. Methods: Skin samples were collected during the surgery (T0) and 12 months after (T12). Immunochemistry assay utilizing a polyclonal anti-AGE antibody was used to evaluate skin AGE deposition, comparing T0 and T12 samples from each patient. Results: All the patients kept both grafts with normal function during the follow-up. AGE immunoreaction was invariably positive on endothelial cells, adipocytes, and dermal collagen fibers. In the epidermal layers, AGE immunoreaction presented several distinct patterns and intensity. In 11 of the 15 patients, there was a change from a diffuse cytoplasmic pattern on T0, to an interkeratinocytic or peripheral only pattern, saving the central cytoplasmic area, on T12. A semiquantitative AGE assessment was made based on immunoreaction intensity, graded on a scale from 0 (negative) to 3+ (strongly positive). In at least 7 patients we observed a clear reduction of AGE immunoreaction intensity from T0 to T12. Conclusions: Based in these results, our conclusion is that reduction of tissue glycosylation may start to be achieved during the first year after a successful PKT, in type 1 diabetic patients.