Bottino Rita, Trucco Massimo, Balamurugan A N, Starzl Thomas E
Division of Immunogenetics, Diabetes Institute, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, School of Medicine, Pittsburgh, PA 15213, USA.
Best Pract Res Clin Gastroenterol. 2002 Jun;16(3):457-74. doi: 10.1053/bega.2002.0318.
Currently, for the patient with type 1 diabetes, a definitive treatment without resorting to the use of exogenous insulin can be achieved only with pancreas or islet cell transplantation. These means of restoring beta-cell mass can completely maintain essentially normal long-term glucose homeostasis, although the need for powerful immunosuppressive regimens limits their application to only a subgroup of adult patients. Apart from the shortage of donors that has limited all kinds of transplantation, however, the widespread use of beta-cell replacement has been precluded until recently by the drawbacks associated with both organ and islet cell transplantation. Although the study of recurrence of diabetes has generated attention, the fundamental obstacle to pancreas and islet transplantation has been, and remains, the alloimmune response. With a better elucidation of the mechanisms of alloengraftment achieved during the last 3 years, the stage has been set for further advances.
目前，对于1型糖尿病患者而言，只有通过胰腺或胰岛细胞移植才能实现不依赖外源性胰岛素的确定性治疗。这些恢复β细胞量的方法能够完全维持基本正常的长期血糖稳态，尽管强大的免疫抑制方案的需求限制了它们仅应用于成年患者的一个亚组。然而，除了供体短缺限制了各种移植之外，直到最近，与器官和胰岛细胞移植相关的缺点一直阻碍着β细胞替代疗法的广泛应用。尽管糖尿病复发的研究已引起关注，但胰腺和胰岛移植的根本障碍一直是且仍然是同种免疫反应。随着过去3年对同种移植机制的更好阐释，进一步取得进展的阶段已经奠定。
