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【nature news编译】母女移植可逆转糖尿病
Mother-to-daughter transplant reverses diabetes
来源
Published online: 19 April 2005; | doi:10.1038/news050418-4
http://www.nature.com/news/2005/050418/pf/050418-4_pf.html
原文及译文
Successful procedure offers fresh hope for patients.
A woman in Japan has had her diabetes reversed by a transplant of insulin-producing cells from her mother. The procedure has given strikingly fast results and marks a departure from previous operations, which relied on cadaver organs as a source of the cells.
The first successful transplantation of such cells, called islet cells, from the pancreas of a non-living donor to a diabetic patient was performed in 2000. Since then, about 100 people have had their diabetic condition reversed by the procedure.
But waiting for a suitable donor can be a problem, particularly in countries such as Japan, where traditional beliefs against removal of organs from the deceased means that donors are in short supply.
For this reason, a team led by Shinichi Matsumoto of Kyoto University Hospital decided to investigate the possibility of extracting islet cells from a live donor. Their first patient was a 27-year-old woman who had become dependent on daily insulin shots after suffering inflammation of the pancreas at a young age. Her 56-year-old mother was the donor.
成功的手术为病人提供了新的希望
日本的一名女性通过从她母亲移植胰岛素生成细胞成功逆转了糖尿病。这个手术产生了及其引人注目的结果，因为它跟以前的手术不同，
以前的手术都是以尸体的器官作为细胞来源的。
这种细胞（胰岛细胞）的移植手术，首次在2000年给一名糖尿病人实施，当时的细胞来自一名已经死亡的供体的胰腺。从那时起，大约100名病人通过这种方式逆转了他们的糖尿病境况。
但是要等待一个合适的供体是困难的，特别象日本这种国家，人们传统上反对从已故的人身上移植器官。这样导致供体都很紧缺。
正是由于这种原因，Shinichi Matsumoto 领导的京都大学医院的一个医疗小组开始研究从活的供体身上提取胰岛细胞的可能性。他们的第一例病人是一名27岁的女性，她在年轻时由于胰腺炎而导致糖尿病，每日通过注射胰岛素来维持生命。她56岁的母亲
是供体。
Delicate procedure
In a day-long operation, the team transplanted about 10mL of tissue from the pancreas of the mother to the daughter. The procedure was a tricky one, since islet cells are notoriously delicate. "It's difficult to extract them and keep them healthy," explains islet transplantation expert Stephanie Amiel of King's College London, UK. She adds that the cells sometimes form clots after the operation.
Matsumoto says that transplants taken from live donors make for healthier cells. Both mother and daughter fared well, he says, and 22 days after the surgery, the young woman no longer needed insulin injections to regulate her blood sugar. "From our experience, this patient has more than double the blood insulin level compared with patients who received one cadaveric islet transplantation," says Matsumoto. The researchers say that people who receive cells from non-living donors tend to become insulin independent only after two or three such procedures.
Amiel says that the daughter's speedy recovery from the recent operation is remarkable given that she only received islets from a portion of the pancreatic tissue; most procedures involve transplanting cells from the entire organ. But Amiel also adds that because the surgery took place in January, the long-term benefits are unclear. "These are quite early days," he says.
Matsumoto says he plans to conduct a further 10 such operations this year.
巧妙的过程
在长达一天的手术中，这个医疗小组成功的从母亲的胰腺中移植了大约10ml的组织给她的女儿。这是一个复杂的过程，因为众所周知胰岛细胞是一个很“娇嫩”的细胞。胰岛移植专家，英国皇家学院的Stephanie Amiel解释到：“将它们提取出来并保持它们的健康是很困难的”。在手术后细胞有时会凝结在一起。
Matsumoto讲到，从活的供体上得到的移植物会更健康一些。他说，母女俩都回复的很好，手术后22天，女儿就不需要通过注射胰岛素来调节血糖了。“根据我们的经验，这个病人血中的胰岛素水平会比其他从已经死亡的供体移植的病人高出2倍”。而且，从已经死亡的供体移植细胞的病人在移植2-3次后就会变成非胰岛素依赖型的糖尿病。
Amiel 说，女孩快速的从手术中恢复有很大的一个原因是她接受的胰岛细胞仅仅来自于胰腺组织的一部分；而大多数情况下，移植的细胞都来自整个器官。Amiel 仍说到，因为这个手术是在1月份做的，它的远期效应还不清楚。“这些都是处于早期阶段”。
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作者:admin@医学,生命科学 2011-03-27 17:14
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