Barker C F, Frangipane L G, Silvers W K
Ann Surg. 1977 Oct;186(4):401-10. doi: 10.1097/00000658-197710000-00001.
Hyperglycemia induced in animals by beta cell toxins or by pancreatectomy can be reversed by pancreatic islet transplantation. Abnormal carbohydrate metabolism in juvenile onset human diabetics has also been corrected, albeit temporarily because of graft rejection, by pancreatic transplantation. It does not necessarily follow that naturally occurring diabetes in animals or adult onset diabetes in man would respond to similar treatment. Islet transplantation was studied in mice with chemically induced or genetically determined diabetes. Streptozotocin-induced diabetic mice were permanently cured by syngeneic islets and, when immunosuppressed, were rendered normoglycemic for six weeks after receiving xenogeneic rat islets. In contrast, histocompatible islets from normoglycemic coisogenic donors were ineffective in hyperglycemic db/db recipients as were xenogeneic rat islets in immunosuppressed db/db hosts. However, when islets were isolated from db/db donors and transplated to genetically normal coisogenic mice, which had been rendered hyperglycemic with streptozotocin, they became normoglycemic. Apparently the metabolic defect in the db/db mice, which is similar in some ways to human maturity onset diabetes, does not reside in their islets as these cells can function normally if transplanted to genetically nondiabetic hosts. In two other types of genetic diabetes (ob/ob and NZO) islet transplantation was more effective. Pancreatic transplantation is unlikely to be the proper treatment for all types of diabetes even if technical and immunological problems are overcome.
由β细胞毒素或胰腺切除诱导的动物高血糖症可通过胰岛移植得到逆转。尽管由于移植物排斥反应只是暂时的，但胰腺移植也纠正了青少年发病型人类糖尿病患者的碳水化合物代谢异常。但这并不意味着动物的自然发生型糖尿病或人类成年发病型糖尿病会对类似治疗产生反应。对化学诱导或基因决定的糖尿病小鼠进行了胰岛移植研究。链脲佐菌素诱导的糖尿病小鼠通过同基因胰岛得到了永久性治愈，并且在免疫抑制的情况下，接受异种大鼠胰岛后六周内血糖维持正常。相比之下，来自血糖正常的同基因供体的组织相容性胰岛对血糖过高的db/db受体无效，免疫抑制的db/db宿主中的异种大鼠胰岛也是如此。然而，当从db/db供体分离胰岛并移植到用链脲佐菌素使其血糖过高的基因正常的同基因小鼠中时，它们的血糖恢复了正常。显然，db/db小鼠的代谢缺陷在某些方面与人类成年发病型糖尿病相似，但并不存在于它们的胰岛中，因为如果移植到基因非糖尿病宿主中，这些细胞可以正常发挥功能。在另外两种类型的遗传性糖尿病（ob/ob和NZO）中，胰岛移植更有效。即使技术和免疫问题得到克服，胰腺移植也不太可能是所有类型糖尿病的合适治疗方法。
