移植部位对移植胰岛长期存活的影响

Influence of graft site on long-term survival of transplanted pancreatic islet

目的观察移植部位对糖尿病小鼠移植胰岛长期存活的影响。方法采用胶原酶P溶液胰管灌注和Ficoll-400不连续密度梯度纯化法获取供体小鼠胰岛。受体糖尿病小鼠分别接受同基因和异基因肾被膜下、小网膜囊和腋窝胰岛移植,监测受体移植后的血糖变化;根据血糖情况取移植胰岛排斥标本,观察不同部位移植胰岛的组织学变化。结果成功分离、纯化供体小鼠胰岛,纯度为(94±5)%或(90±5)%,存活率为(92±3)%。胰岛移植后均能使受体小鼠高血糖逆转至正常。同基因或异基因胰岛移植短期存活状态:肾被膜组与小网膜囊组的血糖降低值比较差异无统计学意义(P>0.05),移植后肾被膜组血糖值显著低于小网膜囊组(P<0.05);腋窝组血糖降低值和血糖值与肾被膜组和小网膜囊组比较,差异均有统计学意义(P<0.05)。同基因或异基因胰岛移植长期存活状态:肾被膜组与小网膜囊组血糖降低值比较差异有统计学意义(P<0.05),且肾被膜组血糖值较低,移植胰岛存活率较高;腋窝组移植胰岛不能达到长期存活;在同一部位,同基因与异基因胰岛移植受体的血糖降低值比较,差异有统计学意义(P<0.05)。组织学检查发现:肾被膜组和小网膜组胰岛完整,有少量炎症细胞浸润;腋窝组胰岛细胞被破坏,大量炎症细胞浸润。结论肾被膜下胰岛移植降血糖效果迅速、稳定,能达到长期存活的目的,可视为胰岛移植的理想部位。

Objective To investigate the influence of graft site on long-term survival of transplanted pancreatic islets in mice with diabetes.Methods Pancreatic islets of donor mice were obtained by infusion of collagenase P solution with pancreatic duct and Ficoll-400 density gradient centrifugation.Homeogenetic and allogenetic pancreatic islet transplantation into renal capsule,lesser omentum and armpit of recipient mice with diabetes was performed,and the values of blood glucose of recipient mice after transplantation were monitored.The transplanted pancreatic islet samples with rejection were selected according to the values of blood glucose,and the histological changes of transplanted pancreatic islets of different graft sites were observed.Results The pancreatic islets of mice were successfully isolated and purified,with the purification of（94±5）% or（90±5）% and survival of（92±3）%.The hyperglycemia state of recipient mice was reversed to normal range after pancreatic islet transplantation.As far as short-term survival of homeogenetic and allogenetic islet transplantation was concerned,there was no significant difference in the decreased value of blood glucose between renal capsule group and lesser omentum group（P0.05）,the value of blood glucose in renal capsule group was significantly lower than that in lesser omentum group after transplantation（P0.05）,and the decreased value of blood glucose and value of blood glucose in armpit group were significantly different from those in renal capsule group and lesser omentum group（P0.05）.As far as long-term survival of homeogenetic and allogenetic islet transplantation was concerned,there were significant differences in the decreased values of blood glucose between renal capsule group and lesser omentum group（P0.05）,with lower value of blood glucose and higher survival of transplanted pancreatic islet in renal capsule group,there was no case of long-term survival in armpit group,and there were significant differences in the decreased values of blood glucose in the same graft site between homeogenetic and allogenetic islet transplantation donors（P0.05）.Histological examination revealed that the pancreatic islets in renal capsule group and lesser omentum group were intact,with less inflammatory cell infiltration,while the pancreatic islet cells in armpit group were destroyed,with more inflammatory cell infiltration.Conclusion Pancreatic islet transplantation into renal capsule may produce fast and stable effect in decreasing blood glucose,and may achieve long-term survival,which can be used as an ideal site for pancreatic islet transplantation.