胰岛移植即刻经血液介导的炎症反应应对策略

Therapeutic strategy for instant blood-mediated inflammatory reaction after islet transplantation

胰岛移植作为治疗1型糖尿病和终末期2型糖尿病的有效手段,可以使患者获得较好的血糖控制能力。即刻经血液介导的炎症反应(IBMIR)是胰岛移植早期出现的非特异性炎症反应,发生后可迅速出现凝血级联和补体系统激活、炎症细胞聚集等,造成大量移植胰岛丢失,严重影响胰岛移植的疗效。如何减轻IBMIR对胰岛造成损伤是目前胰岛移植的研究热点,临床推荐的治疗胰岛移植IBMIR的药物有肝素和肿瘤坏死因子-α抑制剂依那西普。新近研究表明多种方法和药物可以减轻IBMIR对胰岛的损伤,本文就这些临床研究成果和临床前研究成果进行综述,以期为胰岛移植IBMIR的应对提供参考。

As an effective procedure for type 1 diabetes mellitus and end-stage type 2 diabetes mellitus,islet transplantation could enable those patients to obtain proper control of blood glucose levels.Instant bloodmediated inflammatory reaction(IBMIR)is a nonspecific inflammation during early stage after islet transplantation.After IBMIR occurs,coagulation cascade,complement system activation and inflammatory cell aggregation may be immediately provoked,leading to loss of a large quantity of transplant islets,which severely affects clinical efficacy of islet transplantation.How to alleviate the islet damage caused by IBMIR is a hot topic in islet transplantation.Heparin and etanercept,an inhibitor of tumor necrosis factor-α,are recommended as drugs for treating IBMIR following islet transplantation.Recent studies have demonstrated that multiple approaches and drugs may be adopted to mitigate the damage caused by IBMIR to the islets.In this article,the findings in clinical and preclinical researches were reviewed,aiming to provide reference for the management of IBMIR after islet transplantation.