The effect of pancreatic islet transplantation on progression of diabetic retinopathy and neuropathy
The effect of pancreatic islet transplantation on progression of diabetic retinopathy and neuropathy
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DOI：
10.1016/j.transproceed.2005.03.011
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发表时间：
2005-06-01
影响因子：
0.9
通讯作者：
Goss, JA
中科院分区：
文献类型：
--
作者：
Lee, TC;Barshes, NR;Goss, JA
导论.胰岛移植（PIT）仅在过去4年内才成为1型糖尿病的有效治疗方法。因此，PIT对糖尿病神经病变和视网膜病变进展的长期影响尚不清楚。停止或改善糖尿病性神经病变和视网膜病变的益处是特别令人感兴趣的，因为大多数PIT接受者没有发展出糖尿病的晚期并发症。在此，我们描述了12例PIT患者的糖尿病神经病变和视网膜病变的改善和稳定。在2002年1月1日至2004年6月30日期间，有12名患者接受了PIT。目前，有8名患者有足够的随访来评估糖尿病视网膜病变和神经病变的进展。为了评估疾病进展，在整个研究期间由一名眼科医生和一名神经科医生对患者进行检查。使用裂隙灯检查进行眼部检查，同时使用脊髓电图和临床检查评估神经系统状态。结果所有PIT接受者的血红蛋白A（1）C降低，血清C肽升高。所有研究患者的视网膜病变均稳定。1例患者在移植后1年表现出视网膜病变改善。50%的患者表现出糖尿病神经病变的改善或稳定。1例患者在移植后1年的临床检查中发现手指和腕伸肌轻度神经再支配。4名患者的腓肠神经传导速度平均下降19%。结论。我们的系列研究表明，所有PIT接受者的糖尿病视网膜病变均已稳定，50%的患者表现出糖尿病神经病变的稳定甚至改善。
Introduction. Pancreatic islet transplantation (PIT) has only become an effective treatment for type 1 diabetes mellitus within the past 4 years. As a result, the long-term effects of PIT on progression of diabetic neuropathy and retinopathy are unknown. The benefit of halting or improving diabetic neuropathy and retinopathy is of particular interest since most PIT recipients have not developed the advanced complications of diabetes. Herein, we describe the improvement and stabilization of diabetic neuropathy and retinopathy in 12 PIT recipients.Patients and methods. Between January 1, 2002, and June 30, 2004, there have been 12 patients who have received PIT. Currently, there are eight patients who have sufficient follow-up to assess the progression of diabetic retinopathy and neuropathy. To assess for disease progression, patients were examined by a single ophthalmologist and single neurologist throughout the study period. Eye exams were performed using a slit-lamp exam while neurological status was assessed using electromyelograms and clinical exams. Results. All PIT recipients had decreases in hemoglobin A(1)C and increases in serum C-peptide. All study patients had stabilization of their retinopathic disease. One patient demonstrated improvement of retinopathy at 1 year posttransplant. Fifty percent of patients demonstrated improvement or stabilization of their diabetic neuropathy. One patient had mild reinnervation of the fingers and wrist extensors by clinical exam 1 year posttransplant. Four patients exhibited an average decrease of 19% in sural nerve conduction velocities.Conclusion. Our series has demonstrated that all PIT recipients have had stabilization of their diabetic retinopathy and that 50% of patients exhibited stabilization or even improvement of their diabetic neuropathy.