Skip to main content
Erschienen in: Diabetologia 5/2011

01.05.2011 | Article

Co-transplantation of mesenchymal stem cells maintains islet organisation and morphology in mice

verfasst von: C. L. Rackham, P. C. Chagastelles, N. B. Nardi, A. C. Hauge-Evans, P. M. Jones, A. J. F. King

Erschienen in: Diabetologia | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Aims/hypothesis

Recent studies have shown that mesenchymal stem cells (MSCs) secrete several factors that improve survival and function of transplanted islets. Implantation of islets beneath the kidney capsule results in morphological changes, due to interactions of the graft with the host, thus impairing islet function. We co-transplanted MSCs with islets to determine their effects on the remodelling process and studied graft function in a mouse model of minimal islet mass.

Methods

Islets were syngeneically transplanted, either alone or with kidney-derived MSCs, underneath the kidney capsule of streptozotocin-induced diabetic C57Bl/6 mice. Blood glucose levels were monitored and intraperitoneal glucose tolerance tests carried out. Hormone contents of grafts and pancreas were assessed by radioimmunoassay. Graft morphology and vascularisation were evaluated by immunohistochemistry.

Results

MSCs improved the capacity of islet grafts to reverse hyperglycaemia, with 92% of mice co-transplanted with MSCs reverting to normoglycaemia, compared with 42% of those transplanted with islets alone. Average blood glucose concentrations were lower throughout the 1 month monitoring period in MSC co-transplanted mice. MSCs did not alter graft hormone content. Islets co-transplanted with MSCs maintained a morphology that more closely resembled that of islets in the endogenous pancreas, both in terms of size, and of endocrine and endothelial cell distribution. Vascular engraftment was superior in MSC co-transplanted mice, as shown by increased endothelial cell numbers within the endocrine tissue.

Conclusions/interpretation

Co-transplantation of islets with MSCs had a profound impact on the remodelling process, maintaining islet organisation and improving islet revascularisation. MSCs also improved the capacity of islets to reverse hyperglycaemia.
Literatur
1.
Zurück zum Zitat Shapiro AM, Lakey JR, Ryan EA et al (2000) Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med 343:230–238PubMedCrossRef Shapiro AM, Lakey JR, Ryan EA et al (2000) Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med 343:230–238PubMedCrossRef
2.
Zurück zum Zitat Ryan EA, Paty BW, Senior PA et al (2005) Five-year follow-up after clinical islet transplantation. Diabetes 54:2060–2069PubMedCrossRef Ryan EA, Paty BW, Senior PA et al (2005) Five-year follow-up after clinical islet transplantation. Diabetes 54:2060–2069PubMedCrossRef
3.
Zurück zum Zitat Fiorina P, Shapiro AM, Ricordi C, Secchi A (2008) The clinical impact of islet transplantation. Am J Transplant 8:1990–1997PubMedCrossRef Fiorina P, Shapiro AM, Ricordi C, Secchi A (2008) The clinical impact of islet transplantation. Am J Transplant 8:1990–1997PubMedCrossRef
4.
Zurück zum Zitat Langer RM (2010) Islet transplantation: lessons learned since the Edmonton breakthrough. Transplant Proc 42:1421–1424PubMedCrossRef Langer RM (2010) Islet transplantation: lessons learned since the Edmonton breakthrough. Transplant Proc 42:1421–1424PubMedCrossRef
5.
Zurück zum Zitat Davalli AM, Scaglia L, Zangen DH, Hollister J, Bonner-Weir S, Weir GC (1996) Vulnerability of islets in the immediate posttransplantation period. Dynamic changes in structure and function. Diabetes 45:1161–1167PubMedCrossRef Davalli AM, Scaglia L, Zangen DH, Hollister J, Bonner-Weir S, Weir GC (1996) Vulnerability of islets in the immediate posttransplantation period. Dynamic changes in structure and function. Diabetes 45:1161–1167PubMedCrossRef
6.
Zurück zum Zitat Biarnes M, Montolio M, Nacher V, Raurell M, Soler J, Montanya E (2002) Beta-cell death and mass in syngeneically transplanted islets exposed to short- and long-term hyperglycemia. Diabetes 51:66–72PubMedCrossRef Biarnes M, Montolio M, Nacher V, Raurell M, Soler J, Montanya E (2002) Beta-cell death and mass in syngeneically transplanted islets exposed to short- and long-term hyperglycemia. Diabetes 51:66–72PubMedCrossRef
7.
Zurück zum Zitat Miao G, Ostrowski RP, Mace J et al (2006) Dynamic production of hypoxia-inducible factor-1alpha in early transplanted islets. Am J Transplant 6:2636–2643PubMedCrossRef Miao G, Ostrowski RP, Mace J et al (2006) Dynamic production of hypoxia-inducible factor-1alpha in early transplanted islets. Am J Transplant 6:2636–2643PubMedCrossRef
8.
Zurück zum Zitat Brissova M, Powers AC (2008) Revascularization of transplanted islets: can it be improved? Diabetes 57:2269–2271PubMedCrossRef Brissova M, Powers AC (2008) Revascularization of transplanted islets: can it be improved? Diabetes 57:2269–2271PubMedCrossRef
9.
Zurück zum Zitat Menger MD, Jaeger S, Walter P, Feifel G, Hammersen F, Messmer K (1989) Angiogenesis and hemodynamics of microvasculature of transplanted islets of Langerhans. Diabetes 38(Suppl 1):199–201PubMed Menger MD, Jaeger S, Walter P, Feifel G, Hammersen F, Messmer K (1989) Angiogenesis and hemodynamics of microvasculature of transplanted islets of Langerhans. Diabetes 38(Suppl 1):199–201PubMed
10.
Zurück zum Zitat da Silva ML, Chagastelles PC, Nardi NB (2006) Mesenchymal stem cells reside in virtually all post-natal organs and tissues. J Cell Sci 119:2204–2213CrossRef da Silva ML, Chagastelles PC, Nardi NB (2006) Mesenchymal stem cells reside in virtually all post-natal organs and tissues. J Cell Sci 119:2204–2213CrossRef
11.
Zurück zum Zitat Xu YX, Chen L, Wang R et al (2008) Mesenchymal stem cell therapy for diabetes through paracrine mechanisms. Med Hypotheses 71:390–393PubMedCrossRef Xu YX, Chen L, Wang R et al (2008) Mesenchymal stem cell therapy for diabetes through paracrine mechanisms. Med Hypotheses 71:390–393PubMedCrossRef
12.
Zurück zum Zitat Jacobson S, Kumagai-Braesch M, Tibell A, Svensson M, Flodstrom-Tullberg M (2008) Co-transplantation of stromal cells interferes with the rejection of allogeneic islet grafts. Ann NY Acad Sci 1150:213–216PubMedCrossRef Jacobson S, Kumagai-Braesch M, Tibell A, Svensson M, Flodstrom-Tullberg M (2008) Co-transplantation of stromal cells interferes with the rejection of allogeneic islet grafts. Ann NY Acad Sci 1150:213–216PubMedCrossRef
13.
Zurück zum Zitat Figliuzzi M, Cornolti R, Perico N et al (2009) Bone marrow-derived mesenchymal stem cells improve islet graft function in diabetic rats. Transplant Proc 41:1797–1800PubMedCrossRef Figliuzzi M, Cornolti R, Perico N et al (2009) Bone marrow-derived mesenchymal stem cells improve islet graft function in diabetic rats. Transplant Proc 41:1797–1800PubMedCrossRef
14.
Zurück zum Zitat Ding Y, Xu D, Feng G, Bushell A, Muschel RJ, Wood KJ (2009) Mesenchymal stem cells prevent the rejection of fully allogenic islet grafts by the immunosuppressive activity of matrix metalloproteinase-2 and -9. Diabetes 58:1797–1806PubMedCrossRef Ding Y, Xu D, Feng G, Bushell A, Muschel RJ, Wood KJ (2009) Mesenchymal stem cells prevent the rejection of fully allogenic islet grafts by the immunosuppressive activity of matrix metalloproteinase-2 and -9. Diabetes 58:1797–1806PubMedCrossRef
15.
Zurück zum Zitat Solari MG, Srinivasan S, Boumaza I et al (2009) Marginal mass islet transplantation with autologous mesenchymal stem cells promotes long-term islet allograft survival and sustained normoglycemia. J Autoimmun 32:116–124PubMedCrossRef Solari MG, Srinivasan S, Boumaza I et al (2009) Marginal mass islet transplantation with autologous mesenchymal stem cells promotes long-term islet allograft survival and sustained normoglycemia. J Autoimmun 32:116–124PubMedCrossRef
16.
Zurück zum Zitat Longoni B, Szilagyi E, Quaranta P et al (2010) Mesenchymal stem cells prevent acute rejection and prolong graft function in pancreatic islet transplantation. Diabetes Technol Ther 12:435–446PubMedCrossRef Longoni B, Szilagyi E, Quaranta P et al (2010) Mesenchymal stem cells prevent acute rejection and prolong graft function in pancreatic islet transplantation. Diabetes Technol Ther 12:435–446PubMedCrossRef
17.
Zurück zum Zitat Ito T, Itakura S, Todorov I et al (2010) Mesenchymal stem cell and islet co-transplantation promotes graft revascularization and function. Transplantation 89:1438–1445PubMedCrossRef Ito T, Itakura S, Todorov I et al (2010) Mesenchymal stem cell and islet co-transplantation promotes graft revascularization and function. Transplantation 89:1438–1445PubMedCrossRef
18.
Zurück zum Zitat Berman DM, Willman MA, Han D et al (2010) Mesenchymal stem cells enhance allogeneic islet engraftment in nonhuman primates. Diabetes 59:2558–2568PubMedCrossRef Berman DM, Willman MA, Han D et al (2010) Mesenchymal stem cells enhance allogeneic islet engraftment in nonhuman primates. Diabetes 59:2558–2568PubMedCrossRef
19.
Zurück zum Zitat Sordi V, Melzi R, Mercalli A et al (2010) Mesenchymal cells appearing in pancreatic tissue culture are bone marrow-derived stem cells with the capacity to improve transplanted islet function. Stem Cells 28:140–151PubMedCrossRef Sordi V, Melzi R, Mercalli A et al (2010) Mesenchymal cells appearing in pancreatic tissue culture are bone marrow-derived stem cells with the capacity to improve transplanted islet function. Stem Cells 28:140–151PubMedCrossRef
20.
Zurück zum Zitat Merani S, Toso C, Emamaullee J, Shapiro AM (2008) Optimal implantation site for pancreatic islet transplantation. Br J Surg 95:1449–1461PubMedCrossRef Merani S, Toso C, Emamaullee J, Shapiro AM (2008) Optimal implantation site for pancreatic islet transplantation. Br J Surg 95:1449–1461PubMedCrossRef
21.
Zurück zum Zitat Morini S, Braun M, Onori P et al (2006) Morphological changes of isolated rat pancreatic islets: a structural, ultrastructural and morphometric study. J Anat 209:381–392PubMedCrossRef Morini S, Braun M, Onori P et al (2006) Morphological changes of isolated rat pancreatic islets: a structural, ultrastructural and morphometric study. J Anat 209:381–392PubMedCrossRef
22.
Zurück zum Zitat Morini S, Brown ML, Cicalese L et al (2007) Revascularization and remodelling of pancreatic islets grafted under the kidney capsule. J Anat 210:565–577PubMedCrossRef Morini S, Brown ML, Cicalese L et al (2007) Revascularization and remodelling of pancreatic islets grafted under the kidney capsule. J Anat 210:565–577PubMedCrossRef
23.
Zurück zum Zitat King AJ, Fernandes JR, Hollister-Lock J, Nienaber CE, Bonner-Weir S, Weir GC (2007) Normal relationship of beta and non-beta cells not needed for successful islet transplantation. Diabetes 56:2312–2318PubMedCrossRef King AJ, Fernandes JR, Hollister-Lock J, Nienaber CE, Bonner-Weir S, Weir GC (2007) Normal relationship of beta and non-beta cells not needed for successful islet transplantation. Diabetes 56:2312–2318PubMedCrossRef
24.
Zurück zum Zitat Bjaaland T, Hii CS, Jones PM, Howell SL (1988) Role of protein kinase C in arginine-induced glucagon secretion from isolated rat islets of Langerhans. J Mol Endocrinol 1:105–110PubMedCrossRef Bjaaland T, Hii CS, Jones PM, Howell SL (1988) Role of protein kinase C in arginine-induced glucagon secretion from isolated rat islets of Langerhans. J Mol Endocrinol 1:105–110PubMedCrossRef
25.
Zurück zum Zitat Jones PM, Salmon DM, Howell SL (1988) Protein phosphorylation in electrically permeabilized islets of Langerhans. Effects of Ca2+, cyclic AMP, a phorbol ester and noradrenaline. Biochem J 254:397–403PubMed Jones PM, Salmon DM, Howell SL (1988) Protein phosphorylation in electrically permeabilized islets of Langerhans. Effects of Ca2+, cyclic AMP, a phorbol ester and noradrenaline. Biochem J 254:397–403PubMed
26.
Zurück zum Zitat Dong QY, Chen L, Gao GQ et al (2008) Allogeneic diabetic mesenchymal stem cells transplantation in streptozotocin-induced diabetic rat. Clin Invest Med 31:E328–E337PubMed Dong QY, Chen L, Gao GQ et al (2008) Allogeneic diabetic mesenchymal stem cells transplantation in streptozotocin-induced diabetic rat. Clin Invest Med 31:E328–E337PubMed
27.
Zurück zum Zitat Park KS, Kim YS, Kim JH et al (2009) Influence of human allogenic bone marrow and cord blood-derived mesenchymal stem cell secreting trophic factors on ATP (adenosine-5′-triphosphate)/ADP (adenosine-5′-diphosphate) ratio and insulin secretory function of isolated human islets from cadaveric donor. Transplant Proc 41:3813–3818PubMedCrossRef Park KS, Kim YS, Kim JH et al (2009) Influence of human allogenic bone marrow and cord blood-derived mesenchymal stem cell secreting trophic factors on ATP (adenosine-5′-triphosphate)/ADP (adenosine-5′-diphosphate) ratio and insulin secretory function of isolated human islets from cadaveric donor. Transplant Proc 41:3813–3818PubMedCrossRef
28.
Zurück zum Zitat Makhlouf L, Duvivier-Kali VF, Bonner-Weir S, Dieperink H, Weir GC, Sayegh MH (2003) Importance of hyperglycemia on the primary function of allogeneic islet transplants. Transplantation 76:657–664PubMedCrossRef Makhlouf L, Duvivier-Kali VF, Bonner-Weir S, Dieperink H, Weir GC, Sayegh MH (2003) Importance of hyperglycemia on the primary function of allogeneic islet transplants. Transplantation 76:657–664PubMedCrossRef
29.
Zurück zum Zitat Vasir B, Reitz P, Xu G, Sharma A, Bonner-Weir S, Weir GC (2000) Effects of diabetes and hypoxia on gene markers of angiogenesis (HGF, cMET, uPA and uPAR, TGF-alpha, TGF-beta, bFGF and vimentin) in cultured and transplanted rat islets. Diabetologia 43:763–772PubMedCrossRef Vasir B, Reitz P, Xu G, Sharma A, Bonner-Weir S, Weir GC (2000) Effects of diabetes and hypoxia on gene markers of angiogenesis (HGF, cMET, uPA and uPAR, TGF-alpha, TGF-beta, bFGF and vimentin) in cultured and transplanted rat islets. Diabetologia 43:763–772PubMedCrossRef
30.
Zurück zum Zitat Golocheikine A, Tiriveedhi V, Angaswamy N, Benshoff N, SabariNathan R, Mohanakumar T (2010) Cooperative signaling for angiogenesis and neovascularization by VEGF and HGF following islet transplantation. Transplantation 90:725–731PubMedCrossRef Golocheikine A, Tiriveedhi V, Angaswamy N, Benshoff N, SabariNathan R, Mohanakumar T (2010) Cooperative signaling for angiogenesis and neovascularization by VEGF and HGF following islet transplantation. Transplantation 90:725–731PubMedCrossRef
31.
Zurück zum Zitat Brissova M, Shostak A, Shiota M et al (2006) Pancreatic islet production of vascular endothelial growth factor-a is essential for islet vascularization, revascularization, and function. Diabetes 55:2974–2985PubMedCrossRef Brissova M, Shostak A, Shiota M et al (2006) Pancreatic islet production of vascular endothelial growth factor-a is essential for islet vascularization, revascularization, and function. Diabetes 55:2974–2985PubMedCrossRef
32.
Zurück zum Zitat Cabric S, Sanchez J, Johansson U et al (2010) Anchoring of vascular endothelial growth factor to surface-immobilized heparin on pancreatic islets: implications for stimulating islet angiogenesis. Tissue Eng A 16:961–970CrossRef Cabric S, Sanchez J, Johansson U et al (2010) Anchoring of vascular endothelial growth factor to surface-immobilized heparin on pancreatic islets: implications for stimulating islet angiogenesis. Tissue Eng A 16:961–970CrossRef
33.
Zurück zum Zitat Movahedi B, Gysemans C, Jacobs-Tulleneers-Thevissen D, Mathieu C, Pipeleers D (2008) Pancreatic duct cells in human islet cell preparations are a source of angiogenic cytokines interleukin-8 and vascular endothelial growth factor. Diabetes 57:2128–2136PubMedCrossRef Movahedi B, Gysemans C, Jacobs-Tulleneers-Thevissen D, Mathieu C, Pipeleers D (2008) Pancreatic duct cells in human islet cell preparations are a source of angiogenic cytokines interleukin-8 and vascular endothelial growth factor. Diabetes 57:2128–2136PubMedCrossRef
34.
Zurück zum Zitat Johansson U, Rasmusson I, Niclou SP et al (2008) Formation of composite endothelial cell–mesenchymal stem cell islets: a novel approach to promote islet revascularization. Diabetes 57:2393–2401PubMedCrossRef Johansson U, Rasmusson I, Niclou SP et al (2008) Formation of composite endothelial cell–mesenchymal stem cell islets: a novel approach to promote islet revascularization. Diabetes 57:2393–2401PubMedCrossRef
35.
Zurück zum Zitat Ghajar CM, Blevins KS, Hughes CC, George SC, Putnam AJ (2006) Mesenchymal stem cells enhance angiogenesis in mechanically viable prevascularized tissues via early matrix metalloproteinase upregulation. Tissue Eng 12:2875–2888PubMedCrossRef Ghajar CM, Blevins KS, Hughes CC, George SC, Putnam AJ (2006) Mesenchymal stem cells enhance angiogenesis in mechanically viable prevascularized tissues via early matrix metalloproteinase upregulation. Tissue Eng 12:2875–2888PubMedCrossRef
36.
Zurück zum Zitat Potapova IA, Gaudette GR, Brink PR et al (2007) Mesenchymal stem cells support migration, extracellular matrix invasion, proliferation, and survival of endothelial cells in vitro. Stem Cells 25:1761–1768PubMedCrossRef Potapova IA, Gaudette GR, Brink PR et al (2007) Mesenchymal stem cells support migration, extracellular matrix invasion, proliferation, and survival of endothelial cells in vitro. Stem Cells 25:1761–1768PubMedCrossRef
37.
Zurück zum Zitat Kampf C, Mattsson G, Carlsson PO (2006) Size-dependent revascularization of transplanted pancreatic islets. Cell Transplant 15:205–209PubMedCrossRef Kampf C, Mattsson G, Carlsson PO (2006) Size-dependent revascularization of transplanted pancreatic islets. Cell Transplant 15:205–209PubMedCrossRef
38.
Zurück zum Zitat Johansson A, Lau J, Sandberg M, Borg LA, Magnusson PU, Carlsson PO (2009) Endothelial cell signalling supports pancreatic beta cell function in the rat. Diabetologia 52:2385–2394PubMedCrossRef Johansson A, Lau J, Sandberg M, Borg LA, Magnusson PU, Carlsson PO (2009) Endothelial cell signalling supports pancreatic beta cell function in the rat. Diabetologia 52:2385–2394PubMedCrossRef
39.
Zurück zum Zitat Mattsson G, Jansson L, Nordin A, Carlsson PO (2003) Impaired revascularization of transplanted mouse pancreatic islets is chronic and glucose-independent. Transplantation 75:736–739PubMedCrossRef Mattsson G, Jansson L, Nordin A, Carlsson PO (2003) Impaired revascularization of transplanted mouse pancreatic islets is chronic and glucose-independent. Transplantation 75:736–739PubMedCrossRef
40.
Zurück zum Zitat Olsson R, Carlsson PO (2005) Better vascular engraftment and function in pancreatic islets transplanted without prior culture. Diabetologia 48:469–476PubMedCrossRef Olsson R, Carlsson PO (2005) Better vascular engraftment and function in pancreatic islets transplanted without prior culture. Diabetologia 48:469–476PubMedCrossRef
41.
Zurück zum Zitat Lau J, Carlsson PO (2009) Low revascularization of human islets when experimentally transplanted into the liver. Transplantation 87:322–325PubMedCrossRef Lau J, Carlsson PO (2009) Low revascularization of human islets when experimentally transplanted into the liver. Transplantation 87:322–325PubMedCrossRef
42.
Zurück zum Zitat Mattsson G, Jansson L, Carlsson PO (2002) Decreased vascular density in mouse pancreatic islets after transplantation. Diabetes 51:1362–1366PubMedCrossRef Mattsson G, Jansson L, Carlsson PO (2002) Decreased vascular density in mouse pancreatic islets after transplantation. Diabetes 51:1362–1366PubMedCrossRef
43.
Zurück zum Zitat O’Sullivan ES, Johnson AS, Omer A et al (2010) Rat islet cell aggregates are superior to islets for transplantation in microcapsules. Diabetologia 53:937–945PubMedCrossRef O’Sullivan ES, Johnson AS, Omer A et al (2010) Rat islet cell aggregates are superior to islets for transplantation in microcapsules. Diabetologia 53:937–945PubMedCrossRef
44.
Zurück zum Zitat Carvell MJ, Marsh PJ, Persaud SJ, Jones PM (2007) E-cadherin interactions regulate beta-cell proliferation in islet-like structures. Cell Physiol Biochem 20:617–626PubMedCrossRef Carvell MJ, Marsh PJ, Persaud SJ, Jones PM (2007) E-cadherin interactions regulate beta-cell proliferation in islet-like structures. Cell Physiol Biochem 20:617–626PubMedCrossRef
45.
Zurück zum Zitat Bosco D, Orci L, Meda P (1989) Homologous but not heterologous contact increases the insulin secretion of individual pancreatic B cells. Exp Cell Res 184:72–80PubMedCrossRef Bosco D, Orci L, Meda P (1989) Homologous but not heterologous contact increases the insulin secretion of individual pancreatic B cells. Exp Cell Res 184:72–80PubMedCrossRef
46.
Zurück zum Zitat Hauge-Evans AC, King AJ, Carmignac D et al (2009) Somatostatin secreted by islet delta-cells fulfills multiple roles as a paracrine regulator of islet function. Diabetes 58:403–411PubMedCrossRef Hauge-Evans AC, King AJ, Carmignac D et al (2009) Somatostatin secreted by islet delta-cells fulfills multiple roles as a paracrine regulator of islet function. Diabetes 58:403–411PubMedCrossRef
47.
Zurück zum Zitat Jalili RB, Rezakhanlou AM, Hosseini-Tabatabaei A, Ao Z, Warnock GL, Ghahary A (2011) Fibroblast populated collagen matrix promotes islet survival and reduces the number of islets required for diabetes reversal. J Cell Physiol. doi:10.1002/jcp.22515 Jalili RB, Rezakhanlou AM, Hosseini-Tabatabaei A, Ao Z, Warnock GL, Ghahary A (2011) Fibroblast populated collagen matrix promotes islet survival and reduces the number of islets required for diabetes reversal. J Cell Physiol. doi:10.​1002/​jcp.​22515
Metadaten
Titel
Co-transplantation of mesenchymal stem cells maintains islet organisation and morphology in mice
verfasst von
C. L. Rackham
P. C. Chagastelles
N. B. Nardi
A. C. Hauge-Evans
P. M. Jones
A. J. F. King
Publikationsdatum
01.05.2011
Verlag
Springer-Verlag
Erschienen in
Diabetologia / Ausgabe 5/2011
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2053-4

Weitere Artikel der Ausgabe 5/2011

Diabetologia 5/2011 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.