Cross Sarah E, Hughes Stephen J, Partridge Christopher J, Clark Anne, Gray Derek W R, Johnson Paul R V
Nuffield Department of Surgery, Islet Transplant Research Group, University of Oxford, Oxford, United Kingdom.
Transplantation. 2008 Oct 15;86(7):907-11. doi: 10.1097/TP.0b013e318186df87.
: To optimize human islet isolation, it is important to improve our understanding of the collagenase digestion phase. Previous studies of collagenase action were mostly concerned with optimizing its composition, but the delivery and distribution of collagenase at the islet-exocrine interface is likely to be important for liberation of intact islets. The aim of this study was to characterize collagenase distribution in relation to islets in infused human pancreases.
: Human pancreases were retrieved from multiorgan donors with appropriate consent. Tissue samples were taken from the neck, body, and tail regions before and after collagenase infusion by manual syringe-loading (n=10) or recirculating perfusion (n=8), and snap frozen in liquid nitrogen. Frozen sections were immunolabeled for collagenase, insulin, CK19, collagen VI and CD31, then assessed by confocal microscopy.
: Collagenase labeling was widespread throughout the pancreas, associated with collagen VI, and adjacent to CK19-labeled ducts. Collagenase was found within 67%+/-2% of islets ("intraislet"), associated with capillaries (CD31-positive). Intraislet collagenase was observed in 70%+/-3% of islets in the pancreatic tail, compared with 58%+/-2% and 53%+/-2% of islets in the body and neck, respectively (P<0.05 tail vs. neck), and was more prevalent in islets with diameters more than 150 microm (98%+/-1% of islets >150 microm vs. 52%+/-2% of islets <150 microm, P<0.05). There was no difference in intraislet collagenase labeling between perfused and syringe-loaded pancreases.
: Using current infusion techniques, collagenase penetrates the islet interior. This could cause islet fragmentation, and consequently, low islet yields. This study underlies the need to optimize collagenase delivery to preserve intact islets.
为优化人胰岛分离,加深对胶原酶消化阶段的理解很重要。以往对胶原酶作用的研究大多关注优化其组成,但胶原酶在胰岛 - 外分泌界面的递送和分布可能对完整胰岛的释放很重要。本研究的目的是描述胶原酶在灌注人胰腺中与胰岛相关的分布情况。
在获得适当同意后,从多器官捐赠者处获取人胰腺。在胶原酶灌注前后,通过手动注射器加载(n = 10)或循环灌注(n = 8)从颈部、体部和尾部区域采集组织样本,并在液氮中速冻。冰冻切片用胶原酶、胰岛素、细胞角蛋白19(CK19)、Ⅵ型胶原和CD31进行免疫标记,然后通过共聚焦显微镜评估。
胶原酶标记广泛分布于整个胰腺,与Ⅵ型胶原相关,并与CK19标记的导管相邻。在67%±2%的胰岛内发现了胶原酶(“胰岛内”),与毛细血管(CD31阳性)相关。在胰尾70%±3%的胰岛中观察到胰岛内胶原酶,而在体部和颈部分别为58%±2%和53%±2%(尾部与颈部相比,P<0.05),并且在直径大于150微米的胰岛中更普遍(直径>150微米的胰岛中为98%±1%,直径<150微米的胰岛中为52%±2%,P<0.05)。灌注胰腺和注射器加载胰腺之间的胰岛内胶原酶标记没有差异。
使用当前的灌注技术,胶原酶可穿透胰岛内部。这可能导致胰岛破碎,从而导致胰岛产量低。本研究强调了优化胶原酶递送以保存完整胰岛的必要性。