Type 1 diabetes mellitus is an autoimmune disease,which results in the permanent destruction of β-cells of the pancreatic islets of Langerhans.While exogenous insulin therapy has dramatically improved the quality of ...Type 1 diabetes mellitus is an autoimmune disease,which results in the permanent destruction of β-cells of the pancreatic islets of Langerhans.While exogenous insulin therapy has dramatically improved the quality of life,chronic diabetic complications develop in a substantial proportion of subjects and these complications generally progress and worsen over time.Although intensive insulin therapy has proven effective to delay and sometimes prevent the progression of complications such as nephropathy,neuropathy or retinopathy,it is difficult to achieve and maintain long term in most subjects.Reasons for this diff iculty include compliance issues and the increased risk of severe hypoglycemic episodes,which are generally associated with intensification of exogenous insulin therapy.Clinical studies have shown that transplantation of pancreas or purified pancreatic islets can support glucose homeostasis in type 1 diabetic patients.Islet transplantation carries the special advantages of being less invasive and resulting in fewer complications compared with the traditional pancreas or pancreas-kidney transplantation.However,islet transplantation efforts have limitations including the short supply of donor pancreata,the paucity of experienced islet isolation teams,side effects of immunosuppressants and poor long-term results.The purpose of this article is to review recent progress in clinical islet transplantation for the treatment of diabetes.展开更多
Diabetes mellitus remains a major burden.More than 200 million people are affected worldwide,which represents 6%of the world’s population.Type 1 diabetes mellitus is an autoimmune disease,which induces the permanent ...Diabetes mellitus remains a major burden.More than 200 million people are affected worldwide,which represents 6%of the world’s population.Type 1 diabetes mellitus is an autoimmune disease,which induces the permanent destruction of theβ-cells of the pancreatic islets of Langerhans.Although intensive insulin therapy has proven effective to delay and sometimes prevent the progression of complications such as nephropathy,neuropathy or retinopathy,it is difficult to achieve and maintain long term in most subjects.The successes achieved over the last few decades by the transplantation of whole pancreas and isolated islets suggest that diabetes can be cured by the replenishment of deficientβcells.However,islet transplantation efforts have various limitations,including the limited supply of donor pancreata,the paucity of experienced islet isolation teams,side effects of immunosuppressants and poor long term results.The purpose of this article is to review the recent progress in clinical islet transplantation for the treatment of diabetes and to describe the recent progress on pancreatic stem/progenitor cell research,which has opened up several possibilities for the development of new treatments for diabetes.展开更多
基金Supported by The All Saints Health Foundation (in part)
文摘Type 1 diabetes mellitus is an autoimmune disease,which results in the permanent destruction of β-cells of the pancreatic islets of Langerhans.While exogenous insulin therapy has dramatically improved the quality of life,chronic diabetic complications develop in a substantial proportion of subjects and these complications generally progress and worsen over time.Although intensive insulin therapy has proven effective to delay and sometimes prevent the progression of complications such as nephropathy,neuropathy or retinopathy,it is difficult to achieve and maintain long term in most subjects.Reasons for this diff iculty include compliance issues and the increased risk of severe hypoglycemic episodes,which are generally associated with intensification of exogenous insulin therapy.Clinical studies have shown that transplantation of pancreas or purified pancreatic islets can support glucose homeostasis in type 1 diabetic patients.Islet transplantation carries the special advantages of being less invasive and resulting in fewer complications compared with the traditional pancreas or pancreas-kidney transplantation.However,islet transplantation efforts have limitations including the short supply of donor pancreata,the paucity of experienced islet isolation teams,side effects of immunosuppressants and poor long-term results.The purpose of this article is to review recent progress in clinical islet transplantation for the treatment of diabetes.
文摘Diabetes mellitus remains a major burden.More than 200 million people are affected worldwide,which represents 6%of the world’s population.Type 1 diabetes mellitus is an autoimmune disease,which induces the permanent destruction of theβ-cells of the pancreatic islets of Langerhans.Although intensive insulin therapy has proven effective to delay and sometimes prevent the progression of complications such as nephropathy,neuropathy or retinopathy,it is difficult to achieve and maintain long term in most subjects.The successes achieved over the last few decades by the transplantation of whole pancreas and isolated islets suggest that diabetes can be cured by the replenishment of deficientβcells.However,islet transplantation efforts have various limitations,including the limited supply of donor pancreata,the paucity of experienced islet isolation teams,side effects of immunosuppressants and poor long term results.The purpose of this article is to review the recent progress in clinical islet transplantation for the treatment of diabetes and to describe the recent progress on pancreatic stem/progenitor cell research,which has opened up several possibilities for the development of new treatments for diabetes.
