胰岛移植治疗糖尿病的细胞来源研究进展

Research progress on the donor cell sources of pancreatic islet transplantation for treatment of diabetes mellitus

目的综述糖尿病胰岛替代治疗的供体细胞来源及选择的研究进展。方法查阅近年来国内外关于糖尿病胰岛替代治疗及供体细胞来源的相关文献,进行总结分析。结果供体来源短缺仍是胰岛移植(pancreatic islet transplantation,PIT)面临的主要难题。目前,除同种异体/自体供胰外,异种(猪)胰岛、干细胞诱导胰岛及胰岛细胞株制备和应用等方面也取得了重要进展,潜在扩大了可植入细胞来源。结论充足、合适的供体细胞来源是临床广泛开展PIT治疗1型糖尿病(type 1 diabetes mellitus,T1DM)的前提。社会捐赠体系的完善,免疫耐受诱导、基因与生物工程等技术的发展有望解决供体细胞短缺问题,并为临床细胞替代治疗T1DM奠定了基础。

Objective To summarize the research progress on the source and selection of donor cells in the field of islet replacement therapy for diabetes mellitus. Methods Domestic and abroad literature concerning islet replacement therapy for diabetes mellitus, as well as donor source and donor selection was reviewed and analyzed thoroughly.Results The shortage of donor supply is still a major obstacle for the widely clinical application of pancreatic islet transplantation（PIT）. Currently, in addition to the progress on the allogeneic/autologous donor islet supply, some remarkable achievements have been also attained in the application of xenogeneic islet（from pig donor）, as well as islet like cells derived from stem cells and islet cell line, potentially enlarging the source of implantable cells. Conclusion Adequate and suitable donor cell supply is an essential prerequisite for widely clinical application of PIT therapy for type 1 diabetes mellitus（T1DM）. Further perfection of organ donation system, together with development of immune-tolerance induction, gene and bioengineering technology etc. will possibly solve the problem of donor cell shortage and provide a basis for clinical application of cellular replacement therapy for T1DM.