【摘要】 目的猪作为人异种胰岛细胞移植的供体被认为可能是解决人类供体短缺的办法。本研究目的是观察异种胰岛细胞移植对1型糖尿病的治疗效果。方法本研究共3名1型糖尿病自愿受试者,随访6个月。3名患者均在内分泌专科医生的指导下坚持胰岛素治疗,但是长期血糖控制欠佳,血糖波动大,多次出现严重低血糖。供体是新生猪,采用胶原酶消化法分离胰岛细胞,经过体外培养后注入受试者肝内。移植细胞数分别为80万、100万、60万。免疫抑制剂:2例选用环孢霉素(cyclosporine,CSA)+骁悉(mycophenolatemofetil,MMF),1例选用他克莫司(tacrolimus,FK506)+MMF。结果所有病人在移植后1周内均有低热和轻度的肝区疼痛,没有严重的并发症。移植术后仍需胰岛素治疗。术后20d左右,胰岛素用量较术前逐渐减少。6个月后观察,3名受试者血糖均能较好控制,血糖大幅度波动的情况得到改善,HbA1c明显下降,C肽水平显著升高,每天胰岛素用量分别减少了46.7%、25%、20%。结论异种(猪)胰岛细胞移植治疗1型糖尿病,可以使血糖得到理想控制,改善血糖的大幅度波动,低血糖发生率降低,胰岛素用量减少,短期内无明显副反应。更多还原

【Abstract】 Objective Xenotransplantation with porcine islets of langerhans has been proposed as a solution to the shortage of human donors. This study presents the results of a clinical trial of transplanting porcine islets to patients with type 1 diabetic. Method Three patients with type 1 diabetes, as characterized with fluctuation in blood glucose and repeated episodes of severe hypoglycemia despite of intense insulin therapy under the guidance of an endocrinologist, underwent the islet xenotransplantation voluntarily. The neonatal porcine islets were obtained by ductal perfusion with collagenase.The cells were then purified and cultivated in vitro. These three patients were injected with 8×105,1×106 or 6×105 islet cells respectively. Immunosuppressive drug was given immediately before transplantation. Two patients were treated with cyclosporine (CSA) and mycophenolate mofetil (MMF) orally. The third patient was treated with tacrolimus (FK506) and MMF. These three patients were then observed for 6 months. Result All the patients had low grade fever and minor hepatalgia during the first week after the transplantation. No complication was observed. Twenty days after transplantation, all the patients showed a gradual reduction in insulin dependence. The amplitude of glycemic excursions was significantly decreased at 6 months after transplantation. The glycosylated hemoglobin values also dropped obviously after transplantation. The concentration of serum C-peptide was remarkably increased. The dosage of daily insulin required for injection was decreased 46.7%,25% and 20% respectively. Conclusion Patients with type 1 diabetes undergoing porcine islet transplantation have a better glycemic control. The insulin dependence was also reduced. There was no immediate and significant side effect.更多还原