细胞移植治疗糖尿病遇尴尬
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Diabetes1 Treatment Disappoints in New Study

细胞移植法治疗糖尿病遭遇尴尬

  The cell transplants did free patients from insulin shots, but only temporarily: within two years, 86 percent needed insulin again, according to a report to be published Thursday in The New England Journal of Medicine.

  星期四刊登在《新英格兰医学杂志》上的报告显示,细胞移植的确免除了患者注射胰岛素之苦,但是作用却只是暂时的:86%的患者在2年以内再次需要新的胰岛素。

  The patients had severe Type 1 diabetes, also called juvenile2 diabetes, in which the body lacks insulin and people must inject it several times a day to control blood sugar. They were given islet cells from the pancreas of a dead organ donor3.

  患有严重的I型糖尿病,也称为青少年糖尿病的患者体内缺少胰岛素,为了控制血糖必须每天多次注射胰岛素。他们被移植了死亡的器官捐献者的胰脏细胞。

  The transplants do not require major surgery, just a tube inserted into a vein4 in the abdomen5 so that the cells can be dripped into the liver, where they take up residence in tiny blood vessels6. Because the transplanted cells come from someone else, recipients7 must take immune-suppressing drugs for life to prevent rejection8.

  移植手术不需要动大手术,只需要在患者腹部的血管中插入一个导管把细胞倒入患者的肝脏,细胞就依附在肝脏细小的血管上。因为细胞来自于别人体内,接受移植的患者必须终生服用免疫抑制药物,预防产生排异现象。

  The study, involving 36 patients at nine centers in the United States, Canada and Europe, was inspired by a smaller trial published in 2000 that sparked excitement about a transplant technique called the Edmonton protocol9, developed at the University of Alberta. In that initial test, none of the patients needed insulin shots-but when the report was published, none had been followed for more than 14 months. Later, many did need the shots again.

  这项研究是在来自于美国、加拿大和欧洲9个中心的36名患者身上进行的。研究受到2000年发布的一项小规模的试验结果的启发,那一试验提出了让人兴奋的移植技术,即在埃尔伯塔大学发展起来的埃德蒙顿方案。在起初的试验中,没有一个患者需要注射胰岛素。但是到试验报告发布的时候,所有的病人跟踪观察还不到14个月。后来,许多患者还是需要接着注射胰岛素。

  In the newer study, the transplants failed completely within a year in 10 of the 36 patients; but 16 others were off insulin completely, and the remaining 10 needed less insulin than before. By two years, only five were still free of insulin shots. A quarter of the patients had to switch immune-suppressing drugs because of side effects, which sometimes included a drop in kidney function.

  在新近的研究中,在细胞移植的36例患者中,1年以内有10例移植完全失败;但是另外16例患者完全不在需要胰岛素注射,另外10例需要的胰岛素的量也比以前减少了。到2年的时候,仅有5例依然不需要注射胰岛素。由于副作用的原因,包括出现肾功能下降的情况,四分之一的患者不得不停止使用免疫抑制药物。

  For now, the cell transplants are not recommended for most patients.

  所以现在绝大部分患者都没有建议采用细胞移植法。

  "I don't think this is ready for prime time," said Dr. Jonathan S. Bromberg, director of transplantation at Mount Sinai Hospital in Manhattan. He was not involved in the research, but wrote an editorial about it in the same journal.

  “我认为时机还不成熟,” 曼哈顿西奈山医院器官移植主任乔纳森·S·布隆伯格博士说。他没有参与这次研究,但是他在同一期刊上撰写了关于研究报告的社评。

  But he also said the field was advancing so fast that the transplants may actually become a viable10 option in the not-so-distant future.

  但是他说,这一领域发展很快,实际上移植可能在不远的将来成为可靠的治疗方法。

  "I think we've got every reason to believe there will be significant progress," Dr. Bromberg said.

  他表示:“我认为我们有足够的理由相信这一技术将会取得重大的进步。”

  In the meantime, even in their present form, the cell transplants may still help some people - approximately 10 percent of those with Type 1 diabetes, who frequently suffer from severe episodes of low blood sugar, or hypoglycemia, that strike without warning and can cause confusion, fainting or even seizures11.

  同时,即便是在他们现在的情形下,细胞移植对于大约10%的患有I型糖尿病的患者可能依然有用。这些患者经常受到严重的低血糖症状或者低血糖症的折磨,这些疾病会在没有任何征兆的情况下发生,并能诱发神志不清、昏迷甚至惊厥。

  This kind of hypoglycemia can be so severe that patients "can't function in society," said Dr. A.M. James Shapiro, who led the study and is director of the islet transplant program at the University of Alberta. His team developed the Edmonton protocol.

  这种低血糖症会非常严重,可以导致患者“不能正常活动”,领导这项研究的埃尔伯塔胰岛移植项目主任A.M. 詹姆斯·夏皮罗博士表示。他领导的团队开创了埃德蒙顿方案。

  Patients in the study had the condition, but the transplants diminished their hypoglycemic attacks, even when the cells were only partly effective.

  研究中的患者都有上述情况,但在细胞移植后,甚至即便在这些细胞只有部分发挥作用时,他们都免受了低血糖症的困扰。

  In the United States, the cell transplants are considered experimental and are available only in studies. They are more widely available in Canada, Dr. Shapiro said.

  在美国,细胞移植还在试验阶段,只有在研究中可以使用。夏普罗博士介绍说,但在加拿大,细胞移植应用更加广泛。

  Transplanting the entire pancreas can reverse Type 1 diabetes, but it is a major operation and in this country is usually done only when the diabetes is so severe that the patient needs a kidney transplant as well. About 1,500 pancreas transplants a year are performed in the United States. The transplants tend to work for 5 to 10 years, Dr. Bromberg said. Eventually most patients need insulin again.

  完全移植整个胰脏可以彻底治疗I型糖尿病,但是这是一项大手术,而且在美国只有糖尿病已经严重到需要肾移植的时候才通常会被采用。布隆伯格博士说,移植往往可以保证5到10年,但大多数患者最后还是需要注射胰岛素。

  But people with Type 1 do not really need a whole pancreas: they need just the islet cells, which make up only about 3 percent of the organ.

  I型糖尿病患者并不是一定需要整个胰脏的移植,他们只需要相当于整个器官3%的胰岛细胞。

  Researchers have been experimenting with islet transplants since the 1970's. But the cells never survived for long in humans - not until the study reported in 2000 by Dr. Shapiro and his colleagues. His team succeeded because they suspected that the immune-suppressing drugs were killing12 off the islet cells, and they switched to a less toxic13 regimen. It worked.

  研究人员从20世纪70年就开始试验胰岛细胞移植。但是直到2000年夏普罗博士和他的同事发表的研究报告,这些细胞在人体内从来就没有存活过。他的研究小组的成功是由于他们怀疑抑制免疫的药物同时也杀死了胰岛细胞,所以他们成功地使用了一种毒性更小的疗法。

  Even so, too many cells die - half to three quarters, Dr. Shapiro said. If more could survive, patients might be able to go much longer without insulin. Researchers are testing different drug combinations and other refinements14 to improve their results.

  夏普罗博士说,即便如此,太多的细胞-大约有一半岛3/4,还是死亡了。如果更多的细胞能够存活,患者不需要使用胰岛素的时间就可能会延长。研究人员正在试验不同的药物组合和其他的更加精细的方法来提高细胞的成活率。

  "I would be first to admit that it has a long way to go before it matches whole pancreas transplantation," Dr. Shapiro said, but he added that he still expected the cell infusions15 to catch up with whole organ transplants in a few years. The shortage of organ donors16 will be a limiting factor, however.

  “首先我得承认,要达到整个胰脏移植的效果还有很长的路要走,”夏普罗博士承认,但是他接着说,他依然期待在几年的时间里细胞灌输可以赶上整个胰脏器官移植的效果。然而,缺少胰脏捐献者将是一个不利因素。

  Dr. Bromberg said that for most diabetics, new forms of insulin, insulin pumps and glucose17 monitors were improving control of the disease so much that it would be hard to justify18 the risks of a transplant and lifelong immune-suppressing drugs.

  布隆伯格博士说,对于大多数糖尿病患者,新的合成胰岛素、胰岛素泵和血糖监测仪大量使用,用来改善对疾病的监控,但这也使得判断细胞移植和终生使用免疫抑制药物的风险变得困难。

  Cell transplants are being studied primarily in people with Type 1 diabetes, which affects about a million people in the United States. It occurs when a person's immune system, for unknown reasons, attacks the pancreas cells that make insulin.

  细胞移植的研究首先是在I型糖尿病患者身上进行的,患这种疾病的人在美国大约有100万人。这一疾病是由于某种不确知的原因致使免疫系统损害产生胰岛素的胰岛细胞所致。

  Type 2 diabetes is different, and far more common, affecting about 20 million in the United States. Patients produce insulin, but their bodies cannot use it properly. The disease is genetic19, but often develops only when someone who has the genes20 for it also becomes overweight. Type 2 is increasing in many countries as obesity21 rises. (Type 1 is not linked to obesity.)

  II型糖尿病则不同,也更加普遍,在美国大约有2000万患者。患者能够分泌胰岛素,但却不能正常地使用这些胰岛素。这种疾病是遗传所致,但是通常只在带有致病遗传基因同时也体重超标的人才会患这种疾病。II型糖尿病随着肥胖症的增加在很多国家也有所增加。I型糖尿病与肥胖症无关。

  Both forms of the disease can have devastating22 consequences, including blindness, kidney failure and circulatory problems that can lead to amputations.

  两种疾病都可能导致灾难性的后果,包括失明、肾衰竭和导致的截肢的循环系统疾病。



点击收听单词发音收听单词发音  

1 diabetes uPnzu     
n.糖尿病
参考例句:
  • In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者,医生告诫他们不要吃糖。
  • Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。
2 juvenile OkEy2     
n.青少年,少年读物;adj.青少年的,幼稚的
参考例句:
  • For a grown man he acted in a very juvenile manner.身为成年人,他的行为举止显得十分幼稚。
  • Juvenile crime is increasing at a terrifying rate.青少年犯罪正在以惊人的速度增长。
3 donor dstxI     
n.捐献者;赠送人;(组织、器官等的)供体
参考例句:
  • In these cases,the recipient usually takes care of the donor afterwards.在这类情况下,接受捐献者以后通常会照顾捐赠者。
  • The Doctor transplanted the donor's heart to Mike's chest cavity.医生将捐赠者的心脏移植进麦克的胸腔。
4 vein fi9w0     
n.血管,静脉;叶脉,纹理;情绪;vt.使成脉络
参考例句:
  • The girl is not in the vein for singing today.那女孩今天没有心情唱歌。
  • The doctor injects glucose into the patient's vein.医生把葡萄糖注射入病人的静脉。
5 abdomen MfXym     
n.腹,下腹(胸部到腿部的部分)
参考例句:
  • How to know to there is ascarid inside abdomen?怎样知道肚子里面有蛔虫?
  • He was anxious about an off-and-on pain the abdomen.他因时隐时现的腹痛而焦虑。
6 vessels fc9307c2593b522954eadb3ee6c57480     
n.血管( vessel的名词复数 );船;容器;(具有特殊品质或接受特殊品质的)人
参考例句:
  • The river is navigable by vessels of up to 90 tons. 90 吨以下的船只可以从这条河通过。 来自《简明英汉词典》
  • All modern vessels of any size are fitted with radar installations. 所有现代化船只都有雷达装置。 来自《现代汉英综合大词典》
7 recipients 972af69bf73f8ad23a446a346a6f0fff     
adj.接受的;受领的;容纳的;愿意接受的n.收件人;接受者;受领者;接受器
参考例句:
  • The recipients of the prizes had their names printed in the paper. 获奖者的姓名登在报上。 来自《简明英汉词典》
  • The recipients of prizes had their names printed in the paper. 获奖者名单登在报上。 来自《现代英汉综合大词典》
8 rejection FVpxp     
n.拒绝,被拒,抛弃,被弃
参考例句:
  • He decided not to approach her for fear of rejection.他因怕遭拒绝决定不再去找她。
  • The rejection plunged her into the dark depths of despair.遭到拒绝使她陷入了绝望的深渊。
9 protocol nRQxG     
n.议定书,草约,会谈记录,外交礼节
参考例句:
  • We must observe the correct protocol.我们必须遵守应有的礼仪。
  • The statesmen signed a protocol.那些政治家签了议定书。
10 viable mi2wZ     
adj.可行的,切实可行的,能活下去的
参考例句:
  • The scheme is economically viable.这个计划从经济效益来看是可行的。
  • The economy of the country is not viable.这个国家经济是难以维持的。
11 seizures d68658a6ccfd246a0e750fdc12689d94     
n.起获( seizure的名词复数 );没收;充公;起获的赃物
参考例句:
  • Seizures of illicit drugs have increased by 30% this year. 今年违禁药品的扣押增长了30%。 来自《简明英汉词典》
  • Other causes of unconsciousness predisposing to aspiration lung abscess are convulsive seizures. 造成吸入性肺脓肿昏迷的其他原因,有惊厥发作。 来自辞典例句
12 killing kpBziQ     
n.巨额利润;突然赚大钱,发大财
参考例句:
  • Investors are set to make a killing from the sell-off.投资者准备清仓以便大赚一笔。
  • Last week my brother made a killing on Wall Street.上个周我兄弟在华尔街赚了一大笔。
13 toxic inSwc     
adj.有毒的,因中毒引起的
参考例句:
  • The factory had accidentally released a quantity of toxic waste into the sea.这家工厂意外泄漏大量有毒废物到海中。
  • There is a risk that toxic chemicals might be blasted into the atmosphere.爆炸后有毒化学物质可能会进入大气层。
14 refinements 563606dd79d22a8d1e79a3ef42f959e7     
n.(生活)风雅;精炼( refinement的名词复数 );改良品;细微的改良;优雅或高贵的动作
参考例句:
  • The new model has electric windows and other refinements. 新型号有电动窗和其他改良装置。 来自《简明英汉词典》
  • It is possible to add a few useful refinements to the basic system. 对基本系统进行一些有益的改良是可能的。 来自《简明英汉词典》
15 infusions a599e37c1db9952bb8bd450f8702ce2e     
n.沏或泡成的浸液(如茶等)( infusion的名词复数 );注入,注入物
参考例句:
  • Intravenous infusions are also used to administer medications. 静脉输液也可作为一种给药方法。 来自辞典例句
  • INTERPRETATION: GKI infusions significantly reduced plasma glucose concentrations and blood pressure. 结论:静脉滴注GKI显著降低血压和血糖浓度。 来自互联网
16 donors 89b49c2bd44d6d6906d17dca7315044b     
n.捐赠者( donor的名词复数 );献血者;捐血者;器官捐献者
参考例句:
  • Please email us to be removed from our active list of blood donors. 假如你想把自己的名字从献血联系人名单中删去,请给我们发电子邮件。
  • About half this amount comes from individual donors and bequests. 这笔钱大约有一半来自个人捐赠及遗赠。 来自《简明英汉词典》
17 glucose Fyiyz     
n.葡萄糖
参考例句:
  • I gave him an extra dose of glucose to pep him up.我给他多注射了一剂葡萄糖以增强他的活力。
  • The doctor injected glucose into his patient's veins.医生将葡萄糖注入病人的静脉。
18 justify j3DxR     
vt.证明…正当(或有理),为…辩护
参考例句:
  • He tried to justify his absence with lame excuses.他想用站不住脚的借口为自己的缺席辩解。
  • Can you justify your rude behavior to me?你能向我证明你的粗野行为是有道理的吗?
19 genetic PgIxp     
adj.遗传的,遗传学的
参考例句:
  • It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
  • Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。
20 genes 01914f8eac35d7e14afa065217edd8c0     
n.基因( gene的名词复数 )
参考例句:
  • You have good genes from your parents, so you should live a long time. 你从父母那儿获得优良的基因,所以能够活得很长。 来自《简明英汉词典》
  • Differences will help to reveal the functions of the genes. 它们间的差异将会帮助我们揭开基因多种功能。 来自英汉非文学 - 生命科学 - 生物技术的世纪
21 obesity Dv1ya     
n.肥胖,肥大
参考例句:
  • One effect of overeating may be obesity.吃得过多能导致肥胖。
  • Sugar and fat can more easily lead to obesity than some other foods.糖和脂肪比其他食物更容易导致肥胖。
22 devastating muOzlG     
adj.毁灭性的,令人震惊的,强有力的
参考例句:
  • It is the most devastating storm in 20 years.这是20年来破坏性最大的风暴。
  • Affairs do have a devastating effect on marriages.婚外情确实会对婚姻造成毁灭性的影响。
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