Superiority of small islets in human islet transplantation
Superiority of small islets in human islet transplantation
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DOI：
10.2337/db06-0779
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发表时间：
2007-03-01
期刊：
影响因子：
7.7
通讯作者：
Spinas, Giatgen A.
中科院分区：
文献类型：
--
作者：
Lehmann, Roger;Zuellig, Richard A.;Spinas, Giatgen A.
影响胰岛移植效果的因素很多。由于胰岛在移植后早期仅通过扩散提供氧气，并且在门静脉系统中处于缺氧状态，因此我们测试了小的人类胰岛在体外和体内是否上级大的胰岛。我们评估了大小胰岛的胰岛素分泌，并在模拟门静脉内移植环境的缺氧条件下定量细胞死亡。在临床上，我们分析了移植胰岛大小对1型糖尿病患者胰岛素分泌的影响。我们的研究结果提供的证据表明，小胰岛是上级大胰岛在体外胰岛素分泌方面，并表现出较高的存活率在常氧和缺氧培养。与24小时常氧培养相比，缺氧培养48小时后的胰岛体积下降至25%，这是由于大胰岛的优先损失。在人胰岛移植中，分离指数（胰岛体积，以胰岛当量/胰岛数量表示），或更简单地说，胰岛数量，被证明是更可靠的预测刺激C肽反应相比，胰岛体积。因此，胰岛大小似乎是决定人类胰岛移植结果的关键因素。
Many factors influence the outcome of islet transplantation. As islets in the early posttransplant setting are supplied with oxygen by diffusion only and are in a hypoxic state in the portal system, we tested whether small human islets are superior to large islets both in vitro and in VIVO. We assessed insulin secretion of large and small islets and quantified cell death during hypoxic conditions simulating the intraportal transplant environment. In the clinical setting, we analyzed the influence of transplanted islet size on insulin production in patients with type 1 diabetes. Our results provide evidence that small islets are superior to large islets with regard to in vitro insulin secretion and show a higher survival rate during both normoxic and hypoxic culture. Islet volume after 48 h of hypoxic culture decreased to 25% compared with normoxic culture at 24 It due to a preferential loss of large islets. In human islet transplantation, the isolation index (islet volume as expressed in islet equivalents/islet number), or more simply the islet number, proved to be more reliable to predict stimulated C-peptide response compared with islet volume. Thus, islet size seems to be a key factor determining human islet transplantation outcome.