Update on islet cell transplantation for type 1 diabetes.
Update on islet cell transplantation for type 1 diabetes.
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DOI：
10.1055/s-0032-1312569
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发表时间：
2012-06-01
影响因子：
1.4
通讯作者：
Brayman, Kenneth L
中科院分区：
文献类型：
--
作者：
Agarwal, Avinash;Brayman, Kenneth L
尽管现代医学取得了突破，糖尿病仍然是世界范围内发病和死亡的主要原因。随着 20 世纪 60 年代临床胰腺移植的出现和完善，糖尿病的确定性手术治疗得以确立。在接下来的几十年里，出现了涉及胰岛分离和植入的重要发现。临床胰岛细胞移植代表了减少胰岛素需求和使人衰弱的低血糖发作且无需手术的可能性。不幸的是，胰岛细胞移植无法达到与实体器官移植相当的结果。直到埃德蒙顿方案（无类固醇免疫抑制）被描述，该方案证明胰岛细胞移植可能是胰腺移植的可行替代方案。此后，胰岛纯化技术和新型免疫调节剂的重大进展重新引起了人们对胰岛细胞移植的兴趣。然而，该领域仍然面临着胰岛细胞供应有限、植入不足以及慢性免疫抑制的有害影响等挑战。本文讨论临床胰岛细胞移植的历史和现状。
Despite modern medical breakthroughs, diabetes mellitus is a worldwide leading cause of morbidity and mortality. Definitive surgical treatment of diabetes mellitus was established with the advent and refinement of clinical pancreas transplantation in the 1960s. During the following decades, critical discoveries involving islet isolation and engraftment took place. Clinical islet cell transplantation represents the potential for reduced insulin requirements and debilitating hypoglycemic episodes without the morbidity of surgery. Unfortunately, islet cell transplantation was unable to achieve comparable results with solid organ transplantation. This was until the Edmonton protocol (steroid-free immunosuppression) was described, which demonstrated that islet cell transplantation could be a viable alternative to pancreas transplantation. Significant advances in islet purification techniques and novel immunomodulatory agents have since renewed interest in islet cell transplantation. Yet the field is still challenged by a limited supply of islet cells, inadequate engraftment, and the deleterious effects of chronic immunosuppression. This article discusses the history and the current status of clinical islet cell transplantation.