Hasse C, Zielke A, Klöck G, Schlosser A, Zimmermann U, Rothmund M
Department of Surgery, Philipps-University, Marburg, Germany.
Exp Clin Endocrinol Diabetes. 1997;105(1):53-6. doi: 10.1055/s-0029-1211727.
Permanent hypoparathyroidism is one of the most difficult of all endocrine disorders to treat medically. While autotransplantation of parathyroid tissue is clinically established, allotransplantation without immunosuppression is still at the level of animal experiments. Although persons affected by hypoparathyroidism are facing a clearly reduced quality of life, hypoparathyroidism rarely is a life threatening condition. Therefore, systemic immunosuppression for recipients of allotransplants is not justified. A conceptional alternative would be protecting the tissue to be transplanted from the immunologic response by coating it with a semipermeable membrane (microencapsulation). In 1994, we succeeded in iso-, allo- and xenotransplantation of microencapsulated parathyroid tissue in an animal model. Unfortunately, prior to the first clinical use, further analysis of the coating substance (alginate) demonstrated that it has mitogenic properties. Here, we report on the first successful transplantation of microencapsulated parathyroid tissue using a purified, non-mitogenic alginate which is suitable for clinical use.
永久性甲状旁腺功能减退症是所有内分泌疾病中最难通过药物治疗的疾病之一。虽然甲状旁腺组织自体移植已在临床上得到确立,但无免疫抑制的同种异体移植仍处于动物实验阶段。尽管甲状旁腺功能减退症患者的生活质量明显下降,但甲状旁腺功能减退症很少危及生命。因此,对同种异体移植受者进行全身免疫抑制是不合理的。一种概念上的替代方法是通过用半透膜包裹(微囊化)来保护待移植组织免受免疫反应的影响。1994年,我们在动物模型中成功进行了微囊化甲状旁腺组织的同体、异体和异种移植。不幸的是,在首次临床应用之前,对包被物质(藻酸盐)的进一步分析表明它具有促有丝分裂特性。在此,我们报告首次使用适合临床应用的纯化、无促有丝分裂作用的藻酸盐成功进行微囊化甲状旁腺组织移植的情况。