胰腺或胰岛移植后1型糖尿病复发的预测

Prediction of type 1 diabetes recurrence after pancreas or islet transplantation

胰腺或胰岛移植后的1型糖尿病复发(T1DR)是影响远期移植物功能的关键因素之一。由T1DR导致的移植物功能丧失约占7﹪,与慢性同种排斥反应的发生率相当。然而,由于T1DR引起的复发性高血糖缺乏特异性,导致一直以来临床上T1DR发生被严重低估。移植物组织活检提示特异性靶向β细胞的炎性T细胞浸润是诊断T1DR的“金标准”。但是,作为一种有创性操作,组织活检不作为常规筛查T1DR方法。研究显示监测移植受者的胰岛自身抗体和抗原特异性T细胞对T1DR具有预测价值。本文就胰岛自身抗体和抗原特异性T细胞对预测T1DR作一综述。

Type 1 diabetes recurrence(T1DR)after pancreas or islet transplantation is one of the key factors affecting long-term graft function.The loss of graft function caused by T1DR accounts for about 7﹪,which is comparable to the incidence of chronic allograft reaction.However,due to the lack of specificity of recurrent hyperglycemia caused by T1DR,the occurrence of T1DR has been seriously underestimated clinically.A biopsy showing an inflammatory T-cell infiltrate,specifically targeting theβcells is the"gold standard"for the diagnosis of T1DR.As an invasive procedure,biopsy is not used as a generally screening method.Studies have shown that monitoring islet autoantibodies and antigen-specific T cells of transplant recipients has a predictive value for T1DR.This article reviews the prediction of T1DR by islet autoantibodies and antigen-specific T cells.