Hara Y, Fujino M, Nakada K, Kimura K, Adachi K, Li X-K
Laboratory of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
Transplant Proc. 2006 Oct;38(8):2726-8. doi: 10.1016/j.transproceed.2006.08.002.
One of the main barriers to widespread application of islet transplantation is the limited availability of human pancreatic islets. The reduction of graft islet mass for transplantation to a recipient is one of the strategies in islet transplantation. However, transplantation of only a small number of islets may result in primary nonfunction. To optimize the sites and numbers of islets for transplantation, we analyzed these factors using pancreatic islets from Lewis or F344 rats transplanted into rats rendered diabetic by streptozotocin (50 mg/kg IV) and confirmed as such prior to transplantation (>300 mg/dL blood glucose). Approximately 500 to 1500 islets were injected via the portal vein or under the renal capsule into the diabetic F344 rats. The blood glucose level of all animals bearing 1500 syngeneic or allogeneic islets transplanted to the liver or under the kidney capsule exhibited restored normoglycemia (<200 mg/dL) at 1 day after transplantation. Graft function deteriorated after only 3 days in three animals (5.8%). The loss of graft function after 3 days occurred in 10 of 28 rats transplanted with 1000 to 1200 syngeneic islets, 4 of 19 rats transplanted with 800 to 900 syngeneic islets, and 7 of 17 rats transplanted with 500 to 600 syngeneic islets. There was no significant difference in the loss of graft function between the sites of transplantation via portal vein or under the kidney capsule. In conclusion, higher frequencies of primary nonfunction occurred with less than 1500 islets transplanted. They were independent of the sites in the rat-islet transplantation model.
胰岛移植广泛应用的主要障碍之一是人类胰腺胰岛的供应有限。减少移植到受体的移植物胰岛数量是胰岛移植的策略之一。然而,仅移植少量胰岛可能会导致原发性无功能。为了优化胰岛移植的部位和数量,我们使用来自Lewis或F344大鼠的胰岛进行移植,受体大鼠通过链脲佐菌素(50mg/kg静脉注射)诱导糖尿病,并在移植前确认糖尿病状态(血糖>300mg/dL)。将约500至1500个胰岛经门静脉或肾被膜下注射到糖尿病F344大鼠体内。所有移植1500个同基因或异基因胰岛至肝脏或肾被膜下的动物,在移植后1天血糖水平恢复正常(<200mg/dL)。3只动物(5.8%)在移植后仅3天移植物功能就恶化。移植1000至1200个同基因胰岛的28只大鼠中,10只在移植后3天出现移植物功能丧失;移植800至900个同基因胰岛的19只大鼠中,4只出现移植物功能丧失;移植500至600个同基因胰岛的17只大鼠中,7只出现移植物功能丧失。经门静脉或肾被膜下移植部位之间移植物功能丧失无显著差异。总之,移植少于1500个胰岛时原发性无功能的发生率更高。在大鼠胰岛移植模型中,它们与移植部位无关。