Perspectives in diabetes. Islet transplantation with immunoisolation.
Perspectives in diabetes. Islet transplantation with immunoisolation.
复制标题
糖尿病的观点。
作者：
Robert Lanza;S. Sullivan;W. L. Chick
免疫隔离是一种无需免疫抑制药物即可移植胰岛的潜在重要方法。已经设想了免疫隔离系统，其中移植的组织通过人工屏障与宿主的免疫系统分开。这些系统通过允许使用从动物胰腺中分离的胰岛，为人类胰岛获取问题提供了解决方案。所使用的装置被称为生物混合人造器官，因为它们结合了合成的、选择性渗透的膜，可以阻止活体移植物的免疫排斥。已经研究了三种主要类型的生物混合胰腺装置。其中包括与血管系统吻合的装置，如 AV 分流器、扩散室和微胶囊。对糖尿病啮齿动物和狗的研究结果表明，生物混合胰腺装置可显着改善葡萄糖稳态，并且可以发挥一年以上的功能。讨论了这种方法的最新进展，并解决了将该技术应用于临床所必须解决的一些剩余问题。
Immunoisolation is a potentially important approach to transplanting islets without need for immunosuppressive drugs. Immunoisolation systems have been conceived in which the transplanted tissue is separated from the immune system of the host by an artificial barrier. These systems offer a solution to the problem of human islet procurement by permitting use of islets isolated from animal pancreases. The devices used are referred to as biohybrid artificial organs because they combine synthetic, selectively permeable membranes that block immune rejection with living transplants. Three major types of biohybrid pancreas devices have been studied. These include devices anastomosed to the vascular system as AV shunts, diffusion chambers, and microcapsules. Results in diabetic rodents and dogs indicate that biohybrid pancreas devices significantly improve glucose homeostasis and can function for more than a year. Recent progress made with this approach is discussed, and some of the remaining problems that must be resolved to bring this technology to clinical reality are addressed.