人胎胰岛体外预处理和我国的临床胰岛移植

Studies on pretreatment of human fetal islets in vitro and clinical islet transplantation in China

本文报道了多种体外预处理（３７℃培养、２４℃培养与冷冻保存）对人胎胰岛免疫原性的影响，并对我国８３５例Ⅰ型糖尿病胰岛移植临床资料进行了分析。结果显示胰岛的刺激指数较未预处理者显著减低（Ｐ＜０．０５～０．０１），ＨＬＡ－ＤＲ阳性细胞计数与淋巴样细胞计数均较未预处理者显著减少（Ｐ＜０．００１），提示各种预处理均使人胎胰岛免疫原性明显降低。全国８３５例Ⅰ型糖尿病应用人胎胰岛移植后，７２３例（８６．５９％）有效，平均胰岛素需用量、空腹与餐后血糖浓度均较移植前显著减低（Ｐ＜０．００１），平均空腹血清Ｃ肽水平较移植前明显增高（Ｐ＜０．００１），其中５９例（７．０７％）停用胰岛素治疗已持续１．５～８６个月。

The influences of pretreatments(37℃,24℃culture and cryopreservation)on the immunogenecity of human fetal islets and the analysis of clinical data of 835 patients with type 1 diabetes having received islet transplants were reported in this paper.Following the different kinds of pretreatment in vitro,MILCs revealed that the stimulation index of the pretreated fetal islets were markedly reduced compared with those of the unpretreated(P<0. 05￣0.01 ).The HLA-DR positive cell count and lymphoid cell count of the pretreated fetal islets were decreased significantly compared with those of the unpretreated(P<0.001).The results indicated that the immunogenecity of human fetal islets were remarkably reduced by different kinds of pretreatment.In China 835 cases of type 1 diabetics received islet transplants,723(86.59% )recipients were proved to be effective,59 of them(7.07%)became insulin independent for 1.5-86 months(13.56±17.55 mo).