Ar'Rajab A, Ahrén B
Department of Surgery, Lund University, Sweden.
Pancreas. 1992;7(4):435-42. doi: 10.1097/00006676-199207000-00003.
We examined the hypothesis that prevention of hyperglycemia during the critical period immediately following islet transplantation will improve the outcome of the transplantation in streptozotocin-diabetic rats. Two days after intravenous injection of streptozotocin (70 mg/kg), 400 or 1,000 islets were transplanted into the left kidney subcapsular space. A group of rats transplanted with 400 islets was treated with insulin from 1 day before transplantation and for 7 days. Intravenous glucose infusion was performed at 10 days and 3 months after transplantation. In addition, at 3 months, the grafts were examined by light and electron microscopy. We found that rats transplanted with 400 islets without any concomitant insulin administration remained diabetic throughout the 3-month period and no plasma insulin response was induced by glucose infusion in these rats. In contrast, diabetic rats transplanted with 400 islets and treated with insulin for 7 days remained normoglycemic throughout the 3-month period, as did rats transplanted with 1,000 islets. Furthermore, these rats had normal glucose-stimulated insulin secretion both at 10 days and at 3 months after transplantation. Moreover, islet grafts from rats transplanted with 400 islets and administered insulin as well as from rats transplanted with 1,000 islets were morphologically normal, and following removal of the graft, hyperglycemia developed rapidly. In contrast, the islet grafts from rats transplanted with 400 islets without concomitant insulin administration had only few insulin cells. Thus, by preventing hyperglycemia at the time of islet transplantation, the long-term result of islet transplantation was improved. Therefore, the ambient glucose level initially following islet transplantation is critical for the long-term result.
在胰岛移植后的关键时期预防高血糖会改善链脲佐菌素诱导糖尿病大鼠的移植结果。静脉注射链脲佐菌素（70mg/kg）两天后，将400个或1000个胰岛移植到左肾被膜下间隙。一组移植400个胰岛的大鼠在移植前1天开始接受胰岛素治疗，并持续7天。在移植后10天和3个月进行静脉葡萄糖输注。此外，在3个月时，通过光镜和电镜检查移植物。我们发现，移植400个胰岛且未给予任何胰岛素的大鼠在整个3个月期间仍处于糖尿病状态，这些大鼠的葡萄糖输注未诱导出血浆胰岛素反应。相比之下，移植400个胰岛并接受7天胰岛素治疗的糖尿病大鼠在整个3个月期间保持血糖正常，移植1000个胰岛的大鼠也是如此。此外，这些大鼠在移植后10天和3个月时均具有正常的葡萄糖刺激胰岛素分泌。而且，移植400个胰岛并给予胰岛素的大鼠以及移植1000个胰岛的大鼠的胰岛移植物形态正常，移除移植物后，高血糖迅速出现。相比之下，移植400个胰岛且未给予胰岛素的大鼠的胰岛移植物中只有很少的胰岛素细胞。因此，通过在胰岛移植时预防高血糖，改善了胰岛移植的长期结果。所以，胰岛移植后最初的血糖水平对长期结果至关重要。
