胰岛移植的临床与科研现状及展望

Basic research and clinical application of islet transplantation: Current status and future prospects

1型糖尿病是一种慢性自身免疫性疾病,胰岛素对于绝大多数患者有效,然而许多1型糖尿病患者有发生严重的低血糖的风险,甚至危及生命.目前临床上使用细胞替代治疗的方法来恢复血糖的生理稳态,包括胰腺移植和胰岛移植.与胰腺移植相比,胰岛移植有很多优点,但移植后效果一直不理想,直至2000年EDMONTON方案的提出才为胰岛移植带来革命性的突破.然而,一些研究者将移植胰岛的进行性丧失和该方案的不可复制性视为EDMONTON方案的致命缺陷,因此其需要进行进一步改善.本文将简述EDMONTON方案和对其的改进,重点讲述胰岛移植的临床和科研现状及展望.

Type 1 diabetes mellitus is a chronic autoim- mune disease. Although treatment with insulin is effective in most patients with type I diabetes mellitus, it can result in severe hypoglycemia which can be even deadly in some patients. Beta cell replacement, which can be achieved by whole pancreas transplantation or isolated islet cell transplantation, is usually used to restore physiologic glucose homeostasis. Compared with pancreas transplantation, islet transplanta- tion has certain advantages. However, there was not a great breakthrough in islet transplantation until 2000 when the Edmonton protocol was published. However, some investigators believethat progressive graft loss and lack of reproduc- ibility are fatal flaws of the Edmonton protocol. Thus, the protocol needs some improvements. In this article, we briefly describe the Edmonton protocol and its improvements and review the current status and future prospects of islet trans- plantation.