Autologous Pancreatic Islet Transplantation in Human Bone Marrow

被引:70
|
作者
Maffi, Paola [1 ,2 ]
Balzano, Gianpaolo [3 ]
Ponzoni, Maurilio [4 ]
Nano, Rita [2 ,5 ]
Sordi, Valeria [2 ,5 ]
Melzi, Raffaella [2 ,5 ]
Mercalli, Alessia [2 ,5 ]
Scavini, Marina [6 ]
Esposito, Antonio [7 ]
Peccatori, Jacopo [8 ]
Cantarelli, Elisa [2 ,5 ]
Messina, Carlo [8 ]
Bernardi, Massimo [8 ]
Del Maschio, Alessandro [7 ,9 ]
Staudacher, Carlo [3 ,9 ]
Doglioni, Claudio [4 ,9 ]
Ciceri, Fabio [8 ]
Secchi, Antonio [9 ,10 ]
Piemonti, Lorenzo [2 ,5 ]
机构
[1] Univ Milan, Osped San Raffaele, Diabet Res Inst, Islet Transplantat Unit, I-20127 Milan, Italy
[2] Ist Sci San Raffaele, Div Immunol Transplantat & Infect Dis, I-20132 Milan, Italy
[3] Ist Sci San Raffaele, Dept Surg, I-20132 Milan, Italy
[4] Ist Sci San Raffaele, Dept Pathol, I-20132 Milan, Italy
[5] Univ Milan, Osped San Raffaele, Diabet Res Inst, Beta Cell Biol Unit, I-20127 Milan, Italy
[6] Univ Milan, Osped San Raffaele, Diabet Res Inst, Epidemiol & Data Management Unit, I-20127 Milan, Italy
[7] Ist Sci San Raffaele, Dept Radiol, I-20132 Milan, Italy
[8] Ist Sci San Raffaele, Hematol Unit, I-20132 Milan, Italy
[9] Univ Vita Salute San Raffaele, Milan, Italy
[10] Ist Sci San Raffaele, Div Immunol Transplantat & Infect Dis, Clin Transplant Unit, I-20132 Milan, Italy
关键词
POSITRON-EMISSION-TOMOGRAPHY; GRAFT FUNCTION; TISSUE FACTOR; T-CELLS; LIVER; ENGRAFTMENT; LANGERHANS; AUTOTRANSPLANTATION; BLOOD;
D O I
10.2337/db13-0465
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The liver is the current site of choice for pancreatic islet transplantation, even though it is far from being ideal. We recently have shown in mice that the bone marrow (BM) may be a valid alternative to the liver, and here we report a pilot study to test feasibility and safety of BM as a site for islet transplantation in humans. Four patients who developed diabetes after total pancreatectomy were candidates for the autologous transplantation of pancreatic islet. Because the patients had contraindications for intraportal infusion, islets were infused in the BM. In all recipients, islets engrafted successfully as shown by measurable posttransplantation C-peptide levels and histopathological evidence of insulin-producing cells or molecular markers of endocrine tissue in BM biopsy samples analyzed during follow-up. Thus far, we have recorded no adverse events related to the infusion procedure or the presence of islets in the BM. Islet function was sustained for the maximum follow-up of 944 days. The encouraging results of this pilot study provide new perspectives in identifying alternative sites for islet infusion in patients with type 1 diabetes. Moreover, this is the first unequivocal example of successful engraftment of endocrine tissue in the BM in humans.
引用
收藏
页码:3523 / 3531
页数:9
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