Histological changes in endocrine and exocrine pancreatic tissue from patients exposed to incretin‐based therapies
Histological changes in endocrine and exocrine pancreatic tissue from patients exposed to incretin‐based therapies
复制标题
接受肠促胰岛素治疗的患者内分泌和外分泌胰腺组织的组织学变化
作者：
Ueberberg S;Jütte H;Schmidt WE;Nauck MA;Montanya E;Tannapfel A;Meier JJ
目的以胰岛素为基础的治疗与增加胰腺炎的风险有关。最近，在脑死亡器官捐赠者的胰腺组织中发现了各种组织学异常，这些器官捐赠者曾接触过以胰岛素为基础的药物。方法对7例接受胰岛素治疗的2型糖尿病患者(2-I型)、6例非糖尿病患者(2-NI组)、11例非糖尿病患者(非糖尿病组)和9例脑死亡器官供者(BDOD组)的胰腺组织进行检测。结果与非糖尿病组(P<；0.05)相比，2型NI组的胰岛β细胞面积分数减少，但与2-I型患者相比无差异。α细胞面积(P=.30)、β细胞复制(P=.17)和α细胞复制(P=.91)无差异。在腺泡细胞(P=.13)和导管细胞复制(P=.099)方面也没有差异。胰岛素阳性的导管细胞在2型糖尿病组和BDOD组中更为常见(P=0.034)。未检测到胰岛素和胰升糖素的共表达。胰腺上皮内瘤变(Panin)病变非常罕见，均为低度病变(Panin 1a和Panin 1b)，且倾向于在2型糖尿病组中更常见(P=.084)。结论本研究结果未显示2型糖尿病患者胰腺组织学明显异常。可获得的标本数量较少，研究结果的个体间差异很大，因此在解释有关药物对人类胰腺影响的组织学数据时必须谨慎。
AimsIncretin‐based therapies have been associated with an increased risk of pancreatitis. Recently, various histological abnormalities have been reported in human pancreatic tissue from brain‐dead organ donors who had been exposed to incretin‐based drugs. In the present study we examined pancreatic tissue collected at surgery.MethodsHuman pancreatic tissue from 7 type 2‐diabetic patients treated with incretin‐based drugs (type 2‐I), 6 diabetic patients without incretin treatment (type 2‐NI), 11 patients without diabetes (no diabetes group) and 9 brain‐dead organ donors (BDOD group) was examined.ResultsFractional beta‐cell area was reduced in the type 2‐NI group compared to the group without diabetes (P< .05), but there was no difference compared to the type 2‐I patients. Alpha‐cell area (P= .30), beta‐cell replication (P= .17) and alpha‐cell replication (P= .91) were not different. There were also no differences in acinar cell (P= .13) and duct cell replication (P= .099). Insulin‐positive duct cells were more frequent in the type 2‐I and the BDOD groups (P= .034). No co‐expression of insulin and glucagon was detected. Pancreatic intraepithelial neoplasia (PanIN) lesions were very rare, all low‐grade (PanIN 1a and 1b) and tended to occur more frequently in the type 2‐I group (P= .084).ConclusionsThe present results did not reveal marked histological abnormalities in the pancreas of incretin‐treated patients with type 2 diabetes. Low numbers of specimens available and a large inter‐individual variability of the findings warrant caution regarding the interpretation of histological data concerning drug effects on the human pancreas.
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影响因子：
3.8
作者：
Raschi, E.;Piccinni, C.;De Ponti, F.
通讯作者：
De Ponti, F.
DOI：
10.1056/nejmoa1305889
发表时间：
2013-10-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
White, William B;Cannon, Christopher P;Zannad, Faiez
通讯作者：
Zannad, Faiez
影响因子：
8.2
作者：
Butler, P. C.;Matveyenko, A. V.;Dry, S.;Bhushan, A.;Elashoff, R.
通讯作者：
Elashoff, R.
影响因子：
7.7
作者：
Gier B;Matveyenko AV;Kirakossian D;Dawson D;Dry SM;Butler PC
通讯作者：
Butler PC
人类产前生命期间 β 细胞的发育和更新。
影响因子：
5.8
作者：
J. Meier;Christina U. Köhler;Bacel Alkhatib;C. Sergi;T. Junker;H. Klein;W. Schmidt;H. Fritsch
通讯作者：
H. Fritsch