自体外周造血干细胞移植——治疗1型糖尿病的新曙光  

Autologous hematopoietic stem cell transplantation modulates immunocompetent cells and improves β-cell function in Chinese patients with new onset of type 1 diabetes

作　　者：李莉蓉[1] 朱大龙[1] 

机构地区：[1]南京大学医学院附属鼓楼医院内分泌科,210008

出　　处：《中华内分泌代谢杂志》2012年第6期448-451,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：国家“863”项目（2011AA020104）、江苏省重点临床学科项目（XK201105）、南京市卫生局重点科研项目（ZKX07012）

摘　　要：1型糖尿病以自身免疫性胰岛炎和胰岛p细胞损伤为病理特征。尽管胰岛素强化治疗能使1型糖尿病患者实现良好的血糖控制，但该方案难以完全阻止糖尿病并发症的发生。最大限度的保存1型糖尿病患者自身的胰岛功能，是预防或延缓糖尿病并发症的关键。近年研究显示：自体外周造血干细胞移植（AHSCT）可诱导1型糖尿病患者实现免疫耐受，并改善其胰岛功能。本文将重点介绍采用该方案治疗中国人群初发1型糖尿病患者（多以酮症酸中毒起病）的临床研究结果（NCT01341899，Clinical Trials．gov），并简要阐述AHSCT治疗1型糖尿病的可能机制和应用前景。Type 1 diabetes is pathologically characterized by autoimmune insulitis-related islet β-cell destruction. Although intensive insulin therapy for patients with type 1 diabetes can correct hyperglycemia, this therapy does not effectively prevent diabetes-related cardiovascular complications. Hence, preservation of natural β- cell function is critical for the prevention of diabetes-related complications. Recent studies have shown that autologous hematopoietic stem cell transplantation （AHSCT） is a new promising approach for the treatment of type 1 diabetes by reconstitution of immunotolerance and preservation of islet β-cell function. Here we introduce the key results of a clinical trial （ NCT 01341899, ClinicalTrials. gov） performed in Chinese type 1 diabetes patients （most of them with diabetic ketoacidosis at onset） and discuss the potential mechanisms underlying the action of HSCT and its prospects in the clinical management of type 1 diabetes.

关 键 词：糖尿病 1型 自体造血干细胞 免疫功能 C肽 

分 类 号：R587.1[医药卫生—内分泌]