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頁籤選單縮合
題名 | Islet Transplantation: An Update=胰島移植:最新進展 |
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作者姓名(中文) | 莊峻鍠; | 書刊名 | 長庚醫學 |
卷期 | 27:1 2004.01[民93.01] |
頁次 | 頁1-15 |
分類號 | 415.668 |
關鍵詞 | 胰島移植; 糖尿病; Diabetes mellitus; Islet transplantation; |
語文 | 英文(English) |
中文摘要 | 胰島移植以生理方式來精確調節體內葡萄糖衡定,因而可矯正糖尿病所致之代謝與神經血管併發瘧人體胰島移植以往的初步結果相當令人失望,僅有少數成功的病例。但最近成功率大幅提昇的報告,使其成為第1型糖尿病患可能的治療選擇之一。 科學家們長期專研於如何改善胰島移植的成績。人體捐贈胰臟的缺乏驅使許多研究投注於拓展捐贈人口、改良胰島分離及儲存的方法,及尋找胰島的替代來源。為解決移植後胰島生存的問題,於移植前後給予接受者更多的胰島、外源胰島素、高壓氧、pentoxyphylline、15-deoxyspergualine、pravastatin及nordihydorguaiaretic acid均顯示有助於胰島移植體及移植成績。胰島的免疫調節及免疫隔離已被用來克服免疫問題,近來更有新的免疫抑制劑及誘導免疫耐受性的藥物可供使用。 胰島移本成功的病人其血糖趨近正常,具無低血糖的發生。這些病人雖然無第一相胰島素分泌高峰,但其肝臟的葡萄糖製造正常,且組織對葡萄糖的利用改善。移植相關的併發症主要來自於手術本身及免疫抑制藥物。 總結,一旦有更多的胰島來源及更安全的免疫抑制方法,胰島移植將可成為臨床例行的治療。 |
英文摘要 | Islet transplantation offers physiological approach for precise restoration of glucose homeostasis, thereby reversing the metabolic and neurovascular complications of diabetes. In the past, there were only a few successes with human islet transplantation and the initial results were very disappointing. However, recent reports of great successes in islet transplantation have renewed the interest in its as a possible therapeutic option for patients with type 1 diabetes. Scientists have been focusing on methods to improve the outcome of islet transplantation. The shortage of human donor pancreata has led to many efforts to expand the human donor pool, modify islet processing and preservation methods, and search for alternative islet sources. To solve the problems of islet engraftment, treating recipients during the peritransplant period with additional islets exogenous insulin, hyperbaric oxygen, pentoxyphylline, 15-deoxyspergualin, gravastatin and nordihydroguaiaretic acid have all shown to be beneficial for the islet grafts and transplantation results. Immunomodulation and immunosiolation of donor cells have been used to overcome immunological problems, and recently, newer immunosuppressants and agents to induce tolerance have also become available. Patients with successful islet transplatations showed near normal glycemia with no hypoglycemic episode. These patients exhibited normal hepatic glucose production and improved tissue glucose disposal, despite the persistence of blunted first phase insulin peaks. The transplantation-related complications involved primarily the procedure itself and the drugs used for immunosuppression. In conclusion, islet transplantation will become a routine treametn in clinical practice once more islet sources and safer forms of immunosuppression are obtained. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。