Marchetti P, Olack B, Swanson C, Newton M, Scharp D W
Department of Surgery, Washington University School of Medicine, St Louis, MO 63110.
Diabete Metab. 1993 Jan-Feb;19(1):17-24.
Few data have been published so far on the long-term metabolic and endocrine consequences of intrasplenic islet autografts in dogs and the available information mainly deals with glucose response and, more rarely, insulin secretion during intravenous glucose tolerance tests. The effect of islet transplantation on glucagon levels has never been reported. In this study we measured glucose, insulin, total glucagon, and pancreatic glucagon in dogs before and after (up to 1 year) intrasplenic islet autografts. Pancreata were retrieved from 21 adult dogs and the islets were isolated by collagenase digestion. The endocrine tissue was transplanted into the spleen by direct pulp injection. Autografts resulted in normoglycaemia in 19 out of 21 dogs (90%). Among the successfully transplanted dogs, the percentage of functioning grafts was 71% at 1 year. The metabolic and hormonal results of the follow-up showed that fasting glucose and insulin concentrations did not differ significantly before and after transplantation. However, glucose tolerance and insulin secretion on intravenous glucose tolerance testing were significantly reduced in transplanted animals. Fasting total and pancreatic glucagon, and their integrated releases during the test did not change significantly after islet transplantation. These results demonstrate that: 1) long-term function of intrasplenic canine islet autografts can be achieved in high percentages; 2) autotransplanted animals have normal or near normal fasting glucose and insulin levels, but reduced glucose disappearance and insulin secretion on intravenous glucose tolerance tests; 3) normal glucagon secretion is a feature of successful islet grafts.
迄今为止,关于犬脾内胰岛自体移植的长期代谢和内分泌后果的 published 数据很少,现有的信息主要涉及静脉葡萄糖耐量试验期间的葡萄糖反应,以及更罕见的胰岛素分泌。胰岛移植对胰高血糖素水平的影响从未被报道过。在本研究中,我们测量了犬脾内胰岛自体移植前后(长达1年)的葡萄糖、胰岛素、总胰高血糖素和胰腺胰高血糖素。从21只成年犬中取出胰腺,通过胶原酶消化分离胰岛。通过直接注入脾髓将内分泌组织移植到脾脏中。21只犬中有19只(90%)自体移植后血糖正常。在成功移植的犬中,1年后功能正常的移植物百分比为71%。随访的代谢和激素结果表明,移植前后空腹血糖和胰岛素浓度无显著差异。然而,移植动物静脉葡萄糖耐量试验中的葡萄糖耐量和胰岛素分泌显著降低。胰岛移植后空腹总胰高血糖素和胰腺胰高血糖素及其在试验期间的综合释放没有显著变化。这些结果表明:1)犬脾内胰岛自体移植可在高比例下实现长期功能;2)自体移植动物空腹血糖和胰岛素水平正常或接近正常,但静脉葡萄糖耐量试验中葡萄糖消失和胰岛素分泌减少;3)正常的胰高血糖素分泌是成功胰岛移植的一个特征。