Nagaya Masaki, Kubota Sunao, Isogai Akiko, Tadokoro Mamoru, Akashi Katsuya
Department of Emergency and Critical Care Medicine, St. Marianna University, School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.
Surg Today. 2004;34(7):586-92. doi: 10.1007/s00595-004-2789-2.
It has been suggested that islet neogenesis can be induced by incomplete ligation of the pancreatic duct in small animals; however, there has been no report of neogenesis and the proliferation of islets occurring in larger animals. When this procedure was performed in the Vervet monkey, it produced a noticeable increase in duct proliferation, but islet neogenesis was not observed, although the number of monkeys examined was very small. We conducted this study to evaluate whether islet neogenesis and ductular proliferation could be induced in larger animals such as the dog, by partial obstruction of the pancreatic duct.
Incomplete ligation of the pancreatic duct was induced by tying the pancreas around the ventral side of the head with 2-0 silk and reducing the circumference by about 80% to cause partial obstruction.
By 2 weeks after ligation, we saw hyperplasia of the epithelial cells, multilayering of cuboidal cells, and proliferation of ductular cells. The terminal ductules involved in the formation of immunohistochemically insulin-positive islets, and islets, formed adjacent to the alignment of the ductular cells. By 8 weeks after ligation we saw scattered islets, less than 50 micro m in diameter and less than 1 000 microm(2) in area. These cells were immunolabeled for both insulin and cytokeratin, and there was continuity between these insulin-positive cells and terminal ductular cells. Glucagon-positive cells and somatostatin-positive cells were also found adjacent to the alignment of ductular cells.
These results suggest that islets may be differentiated from precursor cells in the pancreatic duct, and that stem cells exist even in adults.
有人提出,在小动物中,胰腺导管不完全结扎可诱导胰岛新生;然而,尚无关于大型动物中胰岛新生和增殖的报道。在黑长尾猴身上进行此操作时,导管增殖显著增加,但未观察到胰岛新生,尽管所检查的猴子数量很少。我们开展这项研究以评估通过部分阻塞胰腺导管,是否能在狗等大型动物中诱导胰岛新生和导管增生。
用2-0丝线在胰腺头部腹侧结扎胰腺,使周长减少约80%以造成部分阻塞,从而诱导胰腺导管不完全结扎。
结扎后2周,我们观察到上皮细胞增生、立方体细胞多层化以及导管细胞增殖。参与形成免疫组化胰岛素阳性胰岛的终末小导管,以及与导管细胞排列相邻形成的胰岛。结扎后8周,我们看到直径小于50微米、面积小于1000平方微米的散在胰岛。这些细胞胰岛素和细胞角蛋白免疫标记均呈阳性,且这些胰岛素阳性细胞与终末小导管细胞之间存在连续性。在导管细胞排列附近还发现了胰高血糖素阳性细胞和生长抑素阳性细胞。
这些结果表明,胰岛可能由胰腺导管中的前体细胞分化而来,并且即使在成年动物中也存在干细胞。