胰岛素诱导的正常血糖水平可减少糖尿病小鼠同种异体胰岛移植后实现正常血糖水平所需的胰岛数量。

Insulin-induced normoglycemia reduces islet number needed to achieve normoglycemia after allogeneic islet transplantation in diabetic mice.

作者信息

Ferrer-Garcia Juan C, Merino-Torres Juan F, Pérez Bermejo Gema, Herrera-Vela Carmen, Ponce-Marco Jose L, Piñon-Selles Francisco

机构信息

Laboratory of Experimental Diabetes, Endocrinology Department, University Hospital La Fe, Av. Campanar 21, Valencia 46009, Spain.

出版信息

Cell Transplant. 2003;12(8):849-57.

DOI:
Abstract

The Edmonton protocol established that insulin independence could be reached with the transplantation of an appropriate number of islet cells. However, to effect a cure, islets from two or three pancreases are needed. The aim of this study was to examine whether normoglycemia, with insulin treatment before and after transplantation, reduces the islet number needed to achieve normoglycemia in allogeneic islet transplantation. Swiss mice were used as donors and recipients. Diabetes was induced by i.p. administration of streptozotocin (180 mg/kg BW). Diabetic mice were transplanted with 300 (n = 16), 400 (n = 16), or 500 (n = 16) islets under the left kidney capsule. For every group, half the animals were kept normoglycemic with insulin treatment from day 4 before transplantation to day 10 after transplantation. At the end of the study, all normoglycemic mice were given an i.p. glucose tolerance test (IPGTT). For statistical analysis, paired or unpaired Student's t-test or ANOVA was used. Only insulin-treated mice achieved normoglycemia by the end of the study (37.5% of animals transplanted with 400 islets and 50% transplanted with 300 or 500 islets). At the end of the study, normoglycemic mice transplanted with 300 allogeneic islets showed better glycosylated hemoglobin (HbA1C) than did normoglycemic mice transplanted with 500 islets (300 islets: 2.7 +/- 0.2%; 500 islets: 3.6 +/- 0.2%; p < 0.05). After the IPGTT, insulin-treated mice transplanted with 500 islets showed abnormal glucose tolerance; however, insulin-treated mice transplanted with 300 or 400 islets showed normal glucose tolerance. Insulin treatment reduced the islet number needed to achieve normoglycemia in allogeneic islet transplantation. The HbA1C and IPGTT results suggest that transplanting smaller numbers of allogeneic islets improves beta-cell function; some studies suggest that this may be due to lower immunogenicity, hypoxia, and inflammation.

摘要

埃德蒙顿方案确定,移植适量胰岛细胞可实现胰岛素非依赖。然而,要实现治愈,则需要两三个胰腺的胰岛。本研究的目的是检验在移植前后使用胰岛素治疗维持血糖正常,是否能减少同种异体胰岛移植中实现血糖正常所需的胰岛数量。以瑞士小鼠作为供体和受体。通过腹腔注射链脲佐菌素(180 mg/kg体重)诱导糖尿病。糖尿病小鼠在左肾被膜下移植300个(n = 16)、400个(n = 16)或500个(n = 16)胰岛。对于每组,一半动物从移植前第4天至移植后第10天通过胰岛素治疗维持血糖正常。在研究结束时,对所有血糖正常的小鼠进行腹腔葡萄糖耐量试验(IPGTT)。进行统计分析时,使用配对或非配对学生t检验或方差分析。仅接受胰岛素治疗的小鼠在研究结束时实现了血糖正常(移植400个胰岛的动物中有37.5%,移植300个或500个胰岛的动物中有50%)。在研究结束时,移植300个同种异体胰岛的血糖正常小鼠的糖化血红蛋白(HbA1C)水平优于移植500个胰岛的血糖正常小鼠(300个胰岛:2.7 +/- 0.2%;500个胰岛:3.6 +/- 0.2%;p < 0.05)。IPGTT后,移植500个胰岛的接受胰岛素治疗的小鼠表现出异常的葡萄糖耐量;然而,移植300个或400个胰岛的接受胰岛素治疗的小鼠表现出正常的葡萄糖耐量。胰岛素治疗减少了同种异体胰岛移植中实现血糖正常所需的胰岛数量。HbA1C和IPGTT结果表明,移植较少数量的同种异体胰岛可改善β细胞功能;一些研究表明,这可能是由于免疫原性较低、缺氧和炎症。

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