中国科技网4月21日报道（张微 编译）詹姆斯 夏皮罗是糖尿病治疗领域世界顶级专家之一，他对自己的最新研究成果无比兴奋。他的研究成果不仅为糖尿病也为其它疾病的治疗建立了新标准。
夏皮罗，加拿大艾伯塔大学医学和牙科学院移植和再生医学研究主席，与在他的实验室工作的同事，博士后研究员安德烈 佩珀一道撰写了研究论文，并发表在四月二十日版的《自然生物技术》期刊上。在这项研究中，作者阐述了皮下胰岛移植的新方案，他们相信这项成果能够降低治疗风险而且对患者的健康大有益处。
胰岛移植是一个治疗方案，暂时让严重的糖尿病患者停止服用胰岛素。
“目前，皮下移植细胞都不成功，”夏皮罗说。“在这项研究中，我们通过开发新血管，利用人体对异体的自然反应能力。通过控制这种反应，我们在临床模型中成功并可靠地击败了糖尿病。这是一个全新的而且令人兴奋的方法，因为它不仅为糖尿病的治疗也为再生医学领域开启了许多机会。
这项新技术，已经进行了临床前的模型测试，是夏皮罗在90年代末开发的用于治疗Ⅰ型糖尿病的“埃德蒙顿方案”的演进。“埃德蒙顿方案”将胰岛细胞移植到肝脏，患者不需要注射胰岛素，虽然在当时被誉为革命性的治疗方案，但是夏皮罗很快意识到肝脏不是一个理想的移植地点，因为大部分的胰岛在几分钟到几个小时的时间里就被破坏了。
夏皮罗的团队开始测试另一个地点——皮下，但一开始这里就被证明不是合适的地方，由于缺乏胰岛细胞生长和繁殖所需的血管。作为这项研究的一个组成部分，他们发明了皮下植入一个临时性的导管，当作可以诱发细胞生长的新血管，就为胰岛移植建了一个理想的家。
研究人员说新的治疗方案具有简便安全的应用潜力。他们补充说，这项治疗不仅为糖尿病患者带来福音，同时也为其它疾病的干细胞治疗评估开启了希望之门。
“这项技术提供了一种可能性，能够将干细胞移植到患者体内一个可以移除的地方，” 佩珀说。“关键的问题是当你获得了一个新的细胞株，而且之前从来没有对患者测试过。如果细胞株存在问题我们有能力把它们从患者身上取出来，这是非常重要。
“这个激动人心的新方法不局限于治疗糖尿病，”夏皮罗说。“再生医学的任何领域都需要“以旧换新”，而且每种疾病的特征各不相同，通过细胞移植只能修补一种基因缺陷，而这个方法为成功地进行皮下移植创造了无限可能。
夏皮罗已经提交这项新的移植技术的专利申请，有望在不久的将来开始人体试验。
Research reveals new possibilities for islet and stem cell transplantation
James Shapiro, one of the world's leading experts in emerging treatments of diabetes, can't help but be excited about his latest research. The results he says, could soon mark a new standard for treatment—not only in diabetes, but in several other diseases as well.
Shapiro, a Canada Research Chair in Transplantation Surgery and Regenerative Medicine in the University of Alberta's Faculty of Medicine & Dentistry, along with Andrew Pepper, a post-doctoral fellow working in his lab, are the lead authors in a study published in the April 20 edition of the journal Nature Biotechnology. In the study, the authors describe developing a new site for islet transplantation under the skin, which they believe will offer less risk and far greater health benefits for patients.
Islet transplantation is a procedure that temporarily allows severe diabetics to stop taking insulin.
"Until now it has been nearly impossible for transplanted cells to function reliably when placed beneath the skin," says Shapiro. "In these studies, we have harnessed the body's natural ability to respond to a foreign body by growing new enriching blood vessels. By controlling this reaction, we have successfully and reliably reversed diabetes in our preclinical models. This approach is new and especially exciting as it opens up a world of opportunities, not only in diabetes, but also across the board in regenerative medicine."
The new technique, tested in preclinical models, is an evolution of the Edmonton Protocol, which Shapiro developed in the late 1990s to treat Type 1 diabetes. In the Edmonton Protocol, islet cells are transplanted into the liver, granting patients insulin independence for a varying amount of time. While hailed as a revolutionary treatment at the time, Shapiro quickly realized the liver wasn't the ideal site for transplantation as most of the islets were destroyed in a matter of minutes to hours. As he considered the future possibility of transplanting human stem cells in place of islets, he realized a better, safer site to implant experimental cells was needed.
Shapiro's team began testing an alternative site underneath the skin, but at first it proved inhospitable for the cells due to a lack of blood vessels needed for the islets to grow and reproduce. As part of their research though, they found that by inserting a temporary catheter tube under the skin, new blood vessels could be induced to grow, making an ideal home for islet transplantation.
The researchers say the new procedure has the potential to be applied safety and easily to patients. They add, it not only offers several benefits to diabetes patients, but also could safely open the door to allow for the assessment of emerging stem cell treatments for other illnesses as well.
"It opens up the possibility of being able to transplant stem cells into patients in a site that can be removed," says Pepper. "That's been a big focus when you've got a new cell line that's never been tested in patients before. The ability to take the cells out if there's a problem is very important."
"This exciting new approach doesn't have to be limited to diabetes," says Shapiro. "For any area of regenerative medicine that requires replacing old cells with new - and there's lots of different disease states where there's just one gene defect that could be corrected by a cell transplant— this opens up an incredible future possibility for successful engraftment beneath the skin."
Shapiro has filed a patent for the new transplant technique and hopes to begin human trials in the very near future.