D'Addio Francesca, Maffi Paola, Vezzulli Paolo, Vergani Andrea, Mello Alessandra, Bassi Roberto, Nano Rita, Falautano Monica, Coppi Elisabetta, Finzi Giovanna, D'Angelo Armando, Fermo Isabella, Pellegatta Fabio, La Rosa Stefano, Magnani Giuseppe, Piemonti Lorenzo, Falini Andrea, Folli Franco, Secchi Antonio, Fiorina Paolo
Corresponding author: Paolo Fiorina,
Diabetes Care. 2014;37(1):267-76. doi: 10.2337/dc13-1663. Epub 2013 Sep 11.
OBJECTIVE Islets after kidney transplantation have been shown to positively affect the quality of life of individuals with type 1 diabetes (T1D) by reducing the burden of diabetes complications, but fewer data are available for islet transplantation alone (ITA). The aim of this study was to assess whether ITA has a positive impact on hemostatic and cerebral abnormalities in individuals with T1D. RESEARCH DESIGN AND METHODS Prothrombotic factors, platelet function/ultrastructure, and cerebral morphology, metabolism, and function have been investigated over a 15-month follow-up period using ELISA/electron microscopy and magnetic resonance imaging, nuclear magnetic resonance spectroscopy, and neuropsychological evaluation (Profile of Mood States test and paced auditory serial addition test) in 22 individuals with T1D who underwent ITA (n = 12) or remained on the waiting list (n = 10). Patients were homogeneous with regard to metabolic criteria, hemostatic parameters, and cerebral morphology/metabolism/function at the time of enrollment on the waiting list. RESULTS At the 15-month follow-up, the group undergoing ITA, but not individuals with T1D who remained on the waiting list, showed 1) improved glucose metabolism; 2) near-normal platelet activation and prothrombotic factor levels; 3) near-normal cerebral metabolism and function; and 4) a near-normal neuropsychological test. CONCLUSIONS ITA, despite immunosuppressive therapy, is associated with a near-normalization of hemostatic and cerebral abnormalities.
目的 肾移植后的胰岛已被证明可通过减轻糖尿病并发症负担对1型糖尿病（T1D）患者的生活质量产生积极影响，但单独进行胰岛移植（ITA）的数据较少。本研究的目的是评估ITA是否对T1D患者的止血和脑部异常有积极影响。 研究设计与方法 在15个月的随访期内，使用酶联免疫吸附测定法（ELISA）/电子显微镜以及磁共振成像、核磁共振波谱和神经心理学评估（情绪状态量表测试和听觉连续加法测试），对22例接受ITA（n = 12）或仍在等待名单上（n = 10）的T1D患者的血栓前因素、血小板功能/超微结构以及脑形态、代谢和功能进行了研究。在列入等待名单时，患者在代谢标准、止血参数和脑形态/代谢/功能方面具有同质性。 结果 在15个月的随访时，接受ITA的组，但仍在等待名单上的T1D患者未出现以下情况：1）血糖代谢改善；2）血小板活化和血栓前因子水平接近正常；3）脑代谢和功能接近正常；4）神经心理学测试接近正常。 结论 尽管进行了免疫抑制治疗，ITA仍与止血和脑部异常的接近正常化有关。
