α-或β-上腺素阻塞不会影响1型糖尿病中移植的小岛细胞对低血糖的反应
Michael R Rickels1, Melena D Bellin2, Darko Stefanovski3
1Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States.
概括
在移植后的1型糖尿病患者中,对葡萄糖的逆调节不需要岛屿移植的交感再内尔化. 在低血糖期间,上腺阻塞没有影响胰岛素抑制或葡萄糖分泌.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 移植免疫学 移植免疫学
背景情况:
- 接受肝内小岛移植的1型糖尿病 (T1D) 患者表现出依赖葡萄糖的胰岛素和葡萄糖素分泌,从而防止低血糖症.
- 移植小岛上的交感性上腺体受体在反调节中的作用尚不清楚.
研究的目的:
- 为了研究上腺素对T1D患者在岛屿移植后的葡萄糖逆调的贡献.
- 为了确定是否需要对岛屿移植的同情性再内内化来防御低血糖症.
主要方法:
- 进行了一项随机的双盲交叉研究.
- 参与者接受了高胰岛素高血糖-低血糖,使用芬托胺 (α-阻塞),醇 (β-阻塞) 或安慰剂.
- 测量包括血压,心率,C-,葡萄糖素,胰腺多,自由脂肪酸和葡萄糖输液率.
主要成果:
- 无论是α-还是β-上腺素阻塞都没有改变紧期间内源性胰岛素抑制.
- 葡萄糖水平在阻塞与安慰剂之间增加了类似的情况,但随着propranolol的使用,这种增加更大.
- 胰腺多是托拉胺更高的;自由脂肪酸和葡萄糖输液率受到普拉诺洛尔的影响.
结论:
- 上腺阻塞并没有减弱移植的小岛对低血糖的反应.
- 在T1D中,对移植后的葡萄糖逆调节来说,小岛移植的交感性再内内化并不必不可少.
- 这些发现表明,小岛移植可以保持葡萄糖平衡,而不依赖于直接的同情输入.
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