CAJ | 학술논문

背景:胰岛移植后可能发生有害的组织不相容性反应,影响细胞的存活及功能.目的:探讨胰岛细胞移植中早期胰岛细胞的损害程度及原因.方法:采用脑死亡自愿捐赠器官供者的胰腺,采用胶原酶P进行消化分离胰岛细胞,测定不同冷缺血时间下胰岛细胞损害程度.将胰岛细胞与血液进行分组培养,HLA匹配组:受者全血+胰岛细胞,受者全血+胰岛细胞+肝素:错配组:受者全血+胰岛细胞,受者全血+胰岛细胞+肝素;对照组:受者伞血+RPMI1640.观察移植早期可能出现的胰岛细胞损害.结果与结论:胰腺切取顺利,在冷缺血5 h以内胰岛细胞活性率都在80%以上,超过8 h活性胰岛细胞数量只有19%甚至更低.人胰岛暴露于未经抗凝的人血液中,胰岛将诱发一个迅速血细胞消耗.血小板、中性粒细胞和单核细胞计数显示,无论HLA错配还是匹配与对照组相比较血细胞都发牛明显的消耗:加入肝素后HLA错配组及HLA匹配组血细胞消耗反应明显减轻;HLA匹配组胰岛细胞体外培养24 h活性胰岛细胞数量高丁HLA错配组(P<0.05),说明良好组织相容性有利于胰岛细胞存活.结果提示冷缺血时间对胰岛细胞活性的影响很大,在冷缺血时间小于5 h的情况下获取的胰腺可以用于临床胰岛细胞移植的胰腺获取;移植到血液的胰岛细胞会有普遍性的炎症性损害及HLA相关性损害.
배경:이도이식후가능발생유해적조직불상용성반응,영향세포적존활급공능.목적:탐토이도세포이식중조기이도세포적손해정도급원인.방법:채용뇌사망자원연증기관공자적이선,채용효원매P진행소화분리이도세포,측정불동랭결혈시간하이도세포손해정도.장이도세포여혈액진행분조배양,HLA필배조:수자전혈+이도세포,수자전혈+이도세포+간소:착배조:수자전혈+이도세포,수자전혈+이도세포+간소;대조조:수자산혈+RPMI1640.관찰이식조기가능출현적이도세포손해.결과여결론:이선절취순리,재랭결혈5 h이내이도세포활성솔도재80%이상,초과8 h활성이도세포수량지유19%심지경저.인이도폭로우미경항응적인혈액중,이도장유발일개신속혈세포소모.혈소판、중성립세포화단핵세포계수현시,무론HLA착배환시필배여대조조상비교혈세포도발우명현적소모:가입간소후HLA착배조급HLA필배조혈세포소모반응명현감경;HLA필배조이도세포체외배양24 h활성이도세포수량고정HLA착배조(P<0.05),설명량호조직상용성유리우이도세포존활.결과제시랭결혈시간대이도세포활성적영향흔대,재랭결혈시간소우5 h적정황하획취적이선가이용우림상이도세포이식적이선획취;이식도혈액적이도세포회유보편성적염증성손해급HLA상관성손해.
BACKGROUND: The incompatible reaction may occur after islet transplantation, which affects the survival and functions of cells. OBJECTIVE: To explore the islet cells injury and its causes during islet transplantation. METHODS: The pancreases of voluntary, brain death, donors were isolated by collagenase, and the islet cells injury was measured with different cold ischemia times. The islet cells were cultured with blood as follow: HLA matching group: recipient whole blood + islet cells, recipient whole blood + islet cells + heparin; HLA mismatching group: recipient whole blood + islet cells, recipient whole blood + islet cells + heparin; Control group: recipient whole blood + RPMI1640. The potential injury to islet cells was observed. RESULTS AND CONCLUSION: The pancreases were smoothly obtained. The activity of islets may be more than 80% within 5 hours of ischemia preservation time, which was less than 19% if the cold ischemia preservation time was over 8 hours. When human islets were exposed to human blood, it will induce a rapid consumption of blood cells, no matter HLA matching or HLA mismatching. After adding heparin into the blood, these events were avoided. At 24 hours of in vitro culture, the number of survival islet cells in the HLA matching group was greater than that of the HLA mismatching group (P < 0.05). The results described that cold ischemia time affects islet cells activity, reduce the cold ischemia preservation time within 5 hours and HLA typing are conductive to enhance the quantity of living islets.