Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Diabetes Metab Res Rev. 2014 Feb;30(2):83-7. doi: 10.1002/dmrr.2484.
The β-cell replacement by islet transplantation is an attractive approach for normalizing blood glucose without hypoglycaemia in patient with type 1 diabetes mellitus (T1D). A pioneer study by the Edmonton group more than a decade ago showed that alloislet transplantation may result in insulin independence for at least 1 year after transplantation. This breakthrough excited researchers, physicians and patients, who felt that the ultimate goal of cure for T1D was at hand. Longer follow-up of patients who underwent islet transplantation showed less favourable results, with only approximately 10% of the patients remaining insulin-free 5 years after transplantation. In the last few years, progress has been made, and the success rate of islet transplantation has steadily increased. Important hurdles, however, related to limited tissue supply and need for life-long immunosuppressive drugs have yet to be overcome. Herein, we review recent achievements in islet transplantation and the challenges that still need to be addressed before this procedure can become a standard therapy for T1D.
胰岛移植通过β细胞替代来实现血糖正常化，可避免 1 型糖尿病（T1D）患者发生低血糖。十多年前，埃德蒙顿研究小组的一项开创性研究表明，同种异体胰岛移植可使患者在移植后至少 1 年内实现胰岛素独立。这一突破令研究人员、医生和患者兴奋不已，他们认为 T1D 的治愈终极目标近在咫尺。对接受胰岛移植的患者进行更长时间的随访发现，结果并不那么理想，只有大约 10%的患者在移植后 5 年内仍无需胰岛素治疗。在过去的几年中，已经取得了进展，胰岛移植的成功率稳步提高。然而，仍然存在一些重要的障碍，如有限的组织供应和对终身免疫抑制药物的需求。在此，我们综述胰岛移植的最新进展以及该治疗方法成为 T1D 标准疗法之前仍需解决的挑战。
