微创胰腺原位骨髓间充质干细胞移植治疗糖尿病

Great progress has been achieved on treatment of diabetes by stem cells transplantation. However, several major obstacles remain. Low trans-differentiation rate and poor function of the cells are the main question. The interaction between stem cells and their supportive microenvironment is critical for their maintenance, function, and survival. The MSCs could adopt β-cell fate upon diabetic microenvironment. Hereatly, In our prior research, we obtained the positive proof by direct MSCs injecting into pancreas. The MSCs adopt β-cell fates and improve hyperglycemia and insufficient insulin upon diabetic pancreatic microenvironment. Similarly, we succeeded to cultivate insulin-producing cells upon simulant pancreatic microenvironment. We could decided it is an efficient strategy to regenerate islets rely on diabetic pancreatic microenvironment. In this study, we projected to improve the method so as to reduce injury. We would transplant MSCs with little injury by fine acus in 5mm Trocar directed by laparoendoscopic single-site surgery (LESS). We would evaluate the fates and mechanism of MSCs and the long-time treat effect through measure the expression of MSCs termly.

干细胞移植治疗糖尿病已经取得很大进展，但仍存在临床应用瓶颈：低转分化效率和缺乏持久的胰岛素分泌作用。干细胞与所处微环境的相互作用决定其分化的方向。糖尿病胰腺微环境对MSCs 具有定向驱动和诱导分化的作用。基于此，申报者在前期研究中，直接在胰腺部位多点微量注射BM-MSCs，获得了缓解高血糖的效果和转分化为胰岛细胞的证据；体外模拟损伤的胰腺微环境，也成功诱导出具有胰岛素分泌的细胞团。因此可以推断：将干细胞直接移植至胰腺，利用损伤的胰腺微环境诱导干细胞分化是实现再生胰岛的有效途径。本课题拟进一步改进细胞移植方法，在微创条件下实现直接胰腺原位移植：利用单孔腹腔镜技术，通过直径5mm Trocar进行多点细针穿刺，微创移植BM-MSCs;移植后取胰腺活检,动态检测移植的BM-MSCs表面分子的表达，进一步探讨其转归及机制以及评价胰腺原位移植方法的长期疗效。