胰岛簇状移植于横纹肌后具有较高的血管密度和氧合。
High vascular density and oxygenation of pancreatic islets transplanted in clusters into striated muscle.
机构信息
Department of Medical Cell Biology, Uppsala University, Sweden.
出版信息
Cell Transplant. 2011;20(5):783-8. doi: 10.3727/096368910X536527. Epub 2010 Nov 5.
Pancreatic islet transplantation is presently almost exclusively performed using the intraportal route for transplantation into the liver. However, islets at this site are poorly revascularized and, when also considering the poor long-term results of clinical islet transplantation, there has in recent years emerged an increased interest to evaluate alternative sites for islet transplantation. Striated muscle is easily accessible and has for decades been used for autotransplantation of parathyroid glands. Moreover, it is almost the only tissue in the adult where physiological angiogenesis occurs. The present study tested the hypothesis that striated muscle would provide good conditions for revascularization and oxygenation of transplanted islets. Because we previously have observed similar revascularization of islets implanted to the renal subcapsular site and intraportally into the liver, islets grafted to the kidney were for simplicity besides native islets used for comparison. Islets grafted into muscle were found to have three times more blood vessels than corresponding islets at the renal subcapsular site at 2 month follow-up, but still less vascular numbers than native islets. The oxygen tension in 2-month-old intramuscular islet grafts was sixfold higher than in corresponding renal subcapsular grafts, and 70% of that in native islets. However, the oxygenation of surrounding muscle was only 50% of that in renal cortex, and connective tissue constituted a larger proportion of the intramuscular than the renal subcapsular grafts, suggesting exaggerated early islet cell death at the former site. We conclude that the intramuscular site provides excellent conditions for vascular engraftment, but that interventions to improve early islet survival likely are needed before clinical application. Such could include bioengineered matrices that not only spatially disperse the islet, but also could provide local supply of oxygen carriers, growth and survival factors, strategies that are much more easily applied at the intramuscular than the intrahepatic site.
胰岛移植目前几乎完全通过门静脉途径移植到肝脏中进行。然而,该部位的胰岛血管化不良,并且考虑到临床胰岛移植的长期效果不佳,近年来人们越来越关注评估胰岛移植的替代部位。横纹肌容易接近,几十年来一直用于甲状旁腺的自体移植。此外,它几乎是成年人体内唯一发生生理性血管生成的组织。本研究检验了以下假设:横纹肌将为移植胰岛的再血管化和氧合提供良好的条件。因为我们之前观察到类似的胰岛在肾被膜下和门静脉内移植后的再血管化,所以除了天然胰岛外,还简单地将移植到肾脏的胰岛用于比较。在 2 个月的随访中,与肾被膜下部位的胰岛相比,移植到肌肉中的胰岛的血管数量增加了两倍,但仍少于天然胰岛。2 个月龄的肌肉内胰岛移植物中的氧张力比相应的肾被膜下移植物高 6 倍,比天然胰岛高 70%。然而,周围肌肉的氧合仅为肾皮质的 50%,并且与肾被膜下移植物相比,结缔组织在肌肉内的比例更大,这表明在前一部位胰岛细胞过早死亡更为严重。我们得出结论,肌肉内部位为血管植入提供了极好的条件,但在临床应用之前,可能需要进行干预以改善早期胰岛的存活。这可能包括生物工程基质,这些基质不仅可以空间分散胰岛,还可以提供局部氧载体、生长和生存因子的供应,这些策略在肌肉内比在肝内更容易实施。