Department of Clinical Anatomy, Tbilisi State Medical University, and Division of Cell Transplantation, Georgian National Institute of Medical Research, DRI Federation, Tbilisi, GA, USA.
Transplantation. 2012 Aug 27;94(4):319-24. doi: 10.1097/TP.0b013e31825e4a83.
Transplanting pancreatic islets is of significant interest for type 1 diabetes mellitus. After intraportal injection of islets, inferior engraftment and eventual loss of transplanted islets constitute major limitations. Therefore, alternative approaches will be helpful. Here, we evaluated in animals whether an isolated venous sac would support survival of transplanted islets, along with correction of hyperglycemia.
Pancreatic islets isolated from adult Lewis rats were transplanted either into an isolated venous sac made from lumbar vein or into the portal vein of syngeneic rats. The integrity and vascular organization of the venous sac was determined by studies of the local microcirculation. The engraftment, survival, and function of transplanted islets were analyzed by histology, including endocrine function in situ and by glycemic control in rats with streptozotocin-induced diabetes.
Transplanted islets showed normal morphology with insulin expression in isolated venous sac during the long term. Transplanted islets received blood supply from vasa vasorum and had access to drainage through venous tributaries in the venous sac. This resulted in restoration of euglycemia in diabetic rats. Removal of islet graft-bearing venous sac in diabetic rats led to recurrence of hyperglycemia. By contrast, euglycemia was not restored in rats treated by intraportal transplantation of islets.
We demonstrated that pancreatic islets successfully engrafted and functioned in the isolated venous sac with ability to restore euglycemia in diabetic rats. Therefore, the isolated venous sac offers a new site for transplantation of pancreatic islets. This would be clinically beneficial as an alternative to intrahepatic islet transplantation.
胰岛移植对于 1 型糖尿病具有重要意义。门静脉内注射胰岛后,移植物的植入不良和最终丧失是主要的局限性。因此,替代方法将是有益的。在这里,我们在动物中评估了一个孤立的静脉囊中是否可以支持移植胰岛的存活,并纠正高血糖。
从成年 Lewis 大鼠中分离的胰岛分别移植到从腰静脉分离的孤立静脉囊中或同种大鼠的门静脉中。通过对局部微循环的研究来确定静脉囊的完整性和血管组织。通过组织学分析,包括原位内分泌功能和链脲佐菌素诱导的糖尿病大鼠的血糖控制,来分析移植胰岛的植入、存活和功能。
在长期的过程中,移植的胰岛在孤立的静脉囊中显示出正常的形态,并且有胰岛素的表达。移植的胰岛接受来自血管腔的血液供应,并通过静脉囊中静脉支流进行引流。这导致糖尿病大鼠的血糖恢复正常。在糖尿病大鼠中移除携带胰岛移植物的静脉囊会导致高血糖复发。相比之下,门静脉内移植胰岛的大鼠血糖未恢复正常。
我们证明了胰岛在孤立的静脉囊中成功植入并发挥功能,能够恢复糖尿病大鼠的正常血糖水平。因此,孤立的静脉囊为胰岛移植提供了一个新的部位。这将作为肝内胰岛移植的替代方法具有临床意义。