Tissue Therapy Unit, Niguarda Hospital, Milan, Italy.
Eur Rev Med Pharmacol Sci. 2018 Mar;22(5):1463-1468. doi: 10.26355/eurrev_201803_14494.
First clinical islet allotransplantation in patients affected by type 1 diabetes mellitus was performed about 30 years ago. Despite the progressive improvement of the success rate, the clinical indication to the islet allotransplantation remains limited to selected patients affected by brittle type 1 diabetes mellitus. The burden of the immunosuppression therapy still represents the main critical issue but other areas might be subject to further improvements, such as the islet production, islet engraftment and long-term function. Several strategies have been proposed to increase the success rate of pancreas digestion and islet purification or to facilitate islet engraftment by reducing islet hypoxia and the inflammatory reaction occurring in the site of transplantation. The co-transplantation of progenitors of beta cell together with the islets has expected to contribute to prolong graft function. Clinical trials are expected soon. Scientific advances, as well as economical efforts, are required to make this procedure a real therapeutical option for patients with type 1 diabetes mellitus.
大约 30 年前，首例 1 型糖尿病患者胰岛同种异体移植临床应用。尽管成功率逐步提高，但胰岛同种异体移植的临床适应证仍然局限于少数脆性 1 型糖尿病患者。免疫抑制治疗的负担仍然是主要的关键问题，但其他领域可能会进一步改善，如胰岛的生产、胰岛移植和长期功能。已经提出了几种策略来提高胰腺消化和胰岛纯化的成功率，或者通过减少移植部位的胰岛缺氧和炎症反应来促进胰岛移植。与胰岛一起共移植β细胞的前体细胞有望延长移植物的功能。预计很快将进行临床试验。需要科学进步和经济努力，使该程序成为 1 型糖尿病患者的真正治疗选择。
