Jin Sang-Man, Kim Kwang-Won
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Korean J Intern Med. 2017 Jan;32(1):62-66. doi: 10.3904/kjim.2016.224. Epub 2017 Jan 1.
Since the report of type 1 diabetes reversal in seven consecutive patients by the Edmonton protocol in 2000, pancreatic islet transplantation has been reappraised based on accumulated clinical evidence. Although initially expected to therapeutically target long-term insulin independence, islet transplantation is now indicated for more specific clinical benefits. With the long-awaited report of the first phase 3 clinical trial in 2016, allogeneic islet transplantation is now transitioning from an experimental to a proven therapy for type 1 diabetes with problematic hypoglycemia. Islet autotransplantation has already been therapeutically proven in chronic pancreatitis with severe abdominal pain refractory to conventional treatments, and it holds promise for preventing diabetes after partial pancreatectomy due to benign pancreatic tumors. Based on current evidence, this review focuses on islet transplantation as a realistic approach to treating diabetes.
自2000年埃德蒙顿方案报告连续7例1型糖尿病患者病情逆转以来，基于积累的临床证据，胰岛移植已被重新评估。尽管最初期望胰岛移植能实现长期脱离胰岛素治疗，但现在胰岛移植因其更具体的临床益处而被应用。随着2016年首个3期临床试验的报告终于出炉，同种异体胰岛移植正从一种实验性治疗转变为治疗伴有低血糖问题的1型糖尿病的已证实疗法。胰岛自体移植已在常规治疗难以缓解严重腹痛的慢性胰腺炎中得到治疗验证，并且有望预防因良性胰腺肿瘤行部分胰腺切除术后发生糖尿病。基于目前的证据，本综述重点关注胰岛移植作为一种治疗糖尿病的切实可行方法。
