Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan.
Center for Clinical Research, Toyama University Hospital, Toyama, Japan.
J Diabetes Investig. 2023 May;14(5):725-729. doi: 10.1111/jdi.13996. Epub 2023 Mar 1.
Pancreatic islet transplantation is a β-cell replacement therapy for people with insulin-deficient diabetes who have difficulty in glycemic control and suffer from frequent severe hypoglycemia. However, the number of islet transplantations carried out is still limited in Asia. We report a case of allogeneic islet transplantation in a 45-year-old Japanese man with type 1 diabetes. Although the islet transplantation was successfully carried out, graft loss was observed on the 18th day. Immunosuppressants were used in accordance with the protocol, and donor-specific anti-human leukocyte antigen antibodies were not detected. Autoimmunity relapse was also not observed. However, the patient had a high titer of anti-glutamic acid decarboxylase antibody from before the islet transplantation, and autoimmunity might thus have affected the β-cells in the transplanted islet. The evidence is still scarce to reach conclusions, and further data accumulation is required to enable proper patient selection before islet transplantation.
胰岛移植是一种β细胞替代疗法，适用于血糖控制困难且频繁发生严重低血糖的胰岛素缺乏型糖尿病患者。然而，亚洲进行的胰岛移植数量仍然有限。我们报告了一例在一名 45 岁的日本男性 1 型糖尿病患者中进行的同种异体胰岛移植。尽管胰岛移植成功进行，但在第 18 天观察到移植物丢失。根据方案使用了免疫抑制剂，并且未检测到供体特异性抗人白细胞抗原抗体。也未观察到自身免疫复发。然而，该患者在胰岛移植前就具有谷氨酸脱羧酶抗体的高滴度，因此自身免疫可能影响了移植胰岛中的β细胞。目前证据还不足以得出结论，需要进一步的数据积累，以便在胰岛移植前对患者进行适当的选择。
