Hayden Melvin R, Sowers James R
University of Missouri School of Medicine Department of Internal Medicine, Endocrinology Diabetes and Metabolism, Diabetes and Cardiovascular Disease Research Group, University of Missouri School of Medicine, Columbia, MO 65212, USA.
Antioxid Redox Signal. 2007 Jul;9(7):891-910. doi: 10.1089/ars.2007.1610.
This review focuses primarily on islet structural and functional changes related to an activated islet renin- angiotensin system (RAS), islet oxidative-redox imbalance, the concurrence of islet fibrosis (pericapillary, intra- and peri-islet), and islet amyloid deposition (pericapillary, intra- and peri-islet). The islet-acinar-portal vascular pathway and the emerging important anatomical and functional region, the islet-exocrine interface, are also discussed. Because there is an associated histopathological islet disease in type 2 diabetes mellitus (T2DM), the term isletopathy is discussed in detail. The isletopathy in T2DM is equally important as the other complications of diabetes. Special stains and special lighting (bright field and crossed polarized light) are utilized, along with light and transmission electron microscopy, in order to better understand islet structural remodeling in T2DM. The importance of an isletopathy in T2DM is supported by numerous remodeling changes within the islet and the islet-exocrine interface. While some of the structural findings are only preliminary observations, additional investigation in this area should lead to the development of new pathophysiological concepts and new therapies regarding the prevention and treatment of T2DM.
本综述主要关注与激活的胰岛肾素 - 血管紧张素系统（RAS）、胰岛氧化 - 还原失衡、胰岛纤维化（毛细血管周围、胰岛内及胰岛周围）和胰岛淀粉样沉积（毛细血管周围、胰岛内及胰岛周围）相关的胰岛结构和功能变化。还讨论了胰岛 - 腺泡 - 门静脉血管途径以及新出现的重要解剖和功能区域——胰岛 - 外分泌界面。由于2型糖尿病（T2DM）存在相关的组织病理学胰岛疾病，因此对“胰岛病变”一词进行了详细讨论。T2DM中的胰岛病变与糖尿病的其他并发症同样重要。利用特殊染色和特殊照明（明场和交叉偏振光），以及光学显微镜和透射电子显微镜，以便更好地了解T2DM中的胰岛结构重塑。胰岛内和胰岛 - 外分泌界面内的众多重塑变化支持了T2DM中胰岛病变的重要性。虽然一些结构发现只是初步观察结果，但该领域的进一步研究应会催生有关T2DM预防和治疗的新病理生理学概念和新疗法。
