Joana R N Lemos1, David A Baidal1,2, Raffaella Poggioli1, Virginia Fuenmayor1, Carmen Chavez1, Ana Alvarez1, Elina Linetsky1, Franck Mauvais-Jarvis2,3,4,5, Camillo Ricordi1,6, Rodolfo Alejandro1,7. 1. Diabetes Research Institute (DRI) and Clinical Cell Transplant Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA. 2. Tulane Center of Excellence in Sex Based Biology & Medicine, New Orleans, LA 70112, USA. 3. Diabetes Discovery Research & Sex-Based Medicine Laboratory, New Orleans, LA 70112, USA. 4. Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA. 5. Southeast Louisiana Veterans Health Care System, New Orleans, LA 70119, USA. 6. Division of Cellular Transplantation, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA. 7. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Abstract
BACKGROUND: Islet transplantation (ITx) has proved to be effective in preventing severe hypoglycemia and improving metabolic control in selected subjects with type 1 diabetes. Long-term graft function remains a challenge. Estrogens have been shown to protect β cells from metabolic stresses and improve revascularization of transplanted human islets in the mouse. We aimed to evaluate the influence of sex in allograft survival of ITx recipients. METHODS: We analyzed a retrospective cohort of ITx recipients (n = 56) followed-up for up to 20 years. Allograft failure was defined as a stimulated C-peptide <0.3 ng/mL during a mixed-meal tolerance test. Subjects were divided into recipients of at least 1 female donor (group 1) and recipients of male donors only (group 2). RESULTS: Group 1 subjects (n = 25) were aged 41.5 ± 8.4 years and group 2 subjects (n = 22) 45.9 ± 7.3 years (P = 0.062). Female recipient frequency was 44.8% (n = 13) in group 1 and 55.2% (n = 16) in group 2 (P = 0.145). Group 2 developed graft failure earlier than group 1 (680 [286-1624] vs 1906 [756-3256] days, P = 0.038). We performed additional analyses on female recipients only from each group (group 1, n = 16; group 2, n = 20). Female recipients in group 1 exhibited prolonged allograft function compared with group 2, after adjustment for confounders (odds ratio, 28.6; 95% CI, 1.3-619.1; P < 0.05). CONCLUSION: Recipients of islets from at least 1 female donor exhibited prolonged graft survival compared with recipients of islets from exclusively male donors. In addition, female recipients exhibited prolonged survival compared with male recipients following ITx of at least 1 female donor.
BACKGROUND: Islet transplantation (ITx) has proved to be effective in preventing severe hypoglycemia and improving metabolic control in selected subjects with type 1 diabetes. Long-term graft function remains a challenge. Estrogens have been shown to protect β cells from metabolic stresses and improve revascularization of transplanted human islets in the mouse. We aimed to evaluate the influence of sex in allograft survival of ITx recipients. METHODS: We analyzed a retrospective cohort of ITx recipients (n = 56) followed-up for up to 20 years. Allograft failure was defined as a stimulated C-peptide <0.3 ng/mL during a mixed-meal tolerance test. Subjects were divided into recipients of at least 1 female donor (group 1) and recipients of male donors only (group 2). RESULTS: Group 1 subjects (n = 25) were aged 41.5 ± 8.4 years and group 2 subjects (n = 22) 45.9 ± 7.3 years (P = 0.062). Female recipient frequency was 44.8% (n = 13) in group 1 and 55.2% (n = 16) in group 2 (P = 0.145). Group 2 developed graft failure earlier than group 1 (680 [286-1624] vs 1906 [756-3256] days, P = 0.038). We performed additional analyses on female recipients only from each group (group 1, n = 16; group 2, n = 20). Female recipients in group 1 exhibited prolonged allograft function compared with group 2, after adjustment for confounders (odds ratio, 28.6; 95% CI, 1.3-619.1; P < 0.05). CONCLUSION: Recipients of islets from at least 1 female donor exhibited prolonged graft survival compared with recipients of islets from exclusively male donors. In addition, female recipients exhibited prolonged survival compared with male recipients following ITx of at least 1 female donor.
Authors: Joseph P Tiano; Viviane Delghingaro-Augusto; Cedric Le May; Suhuan Liu; Meenakshi K Kaw; Saja S Khuder; Martin G Latour; Surabhi A Bhatt; Kenneth S Korach; Sonia M Najjar; Marc Prentki; Franck Mauvais-Jarvis Journal: J Clin Invest Date: 2011-07-11 Impact factor: 14.808
Authors: George W Burke; Francesco Vendrame; Sahil K Virdi; G Ciancio; Linda Chen; Phillip Ruiz; Shari Messinger; Helena K Reijonen; Alberto Pugliese Journal: Curr Diab Rep Date: 2015-12 Impact factor: 4.810
Authors: Suhuan Liu; Cedric Le May; Winifred P S Wong; Robert D Ward; Deborah J Clegg; Marco Marcelli; Kenneth S Korach; Franck Mauvais-Jarvis Journal: Diabetes Date: 2009-07-08 Impact factor: 9.461
Authors: Enza Marchese; Caitlin Rodeghier; Rebecca S Monson; Benjamin McCracken; Tingqi Shi; Wesley Schrock; Joan Martellotto; Jose Oberholzer; Kirstie K Danielson Journal: Diabetes Care Date: 2015-09-17 Impact factor: 19.112