Endocrine-related neurological function recovery in pancreatic transplantation

Abstract

BACKGROUND

Pancreas transplantation (PT) has emerged as a critical therapeutic intervention for patients with type 1 diabetes mellitus (T1DM). This procedure restores neuroendocrine communication, which is essential for optimal pancreatic function and insulin regulation. The recovery process involves multiple phases, including neural regeneration, revascularization, and the re-establishment of synaptic connections, all of which contribute to the restoration of both endocrine and neurological functions.

AIM

To systematically examine the mechanisms underlying neurological recovery following PT, to explore the role of endocrine factors in restoring neurofunctional integrity, and to evaluate the impact of immunosuppressive therapy on nerve regeneration and its clinical outcomes.

METHODS

A comprehensive literature search was conducted across international databases such as PubMed, Web of Science, and Cochrane Library to identify studies addressing PT, neurological recovery, and endocrine regulation. Inclusion criteria encompassed randomized controlled trials, cohort studies, and systematic reviews. The review focused on the neurogenic mechanisms activated post-transplantation, the effect of glycemic control on nerve repair, and the implications of immunosuppressive drugs on the process of neurological recovery.

RESULTS

A total of 211 articles were initially identified through the literature search across international databases such as PubMed, Web of Science, and Cochrane Library. Following a detailed evaluation and the application of inclusion and exclusion criteria, 56 articles were further reviewed, and 8 were selected for the final analysis. Additionally, a comprehensive patent search yielded 168 patents, out of which 6 were selected for further examination. These sources, including both journal literature and patents, offer significant insights into the mechanisms of neurological recovery and endocrine function following PT, with an emphasis on nerve regeneration, glycemic control, and the impact of immunosuppressive therapy.

CONCLUSION

PT represents a promising intervention for restoring both endocrine and neurological functions in patients with T1DM. Glycemic control, neural regeneration, and the restoration of neuroendocrine signaling are key components of successful recovery. While the procedure yields substantial improvements in nerve function, challenges persist, particularly in patients with long-standing diabetes or severe neuropathy. The dual impact of immunosuppressive drugs on immune suppression and neurotoxicity necessitates careful management. Future research should focus on refining immunosuppressive protocols and exploring advanced therapeutic options, including stem cell-based interventions, to enhance neural regeneration and further improve clinical outcomes.

Keywords: Pancreas transplantation; Type 1 diabetes mellitus; Neurological recovery; Endocrine regulation; Glycemic control; Nerve regeneration; Immunosuppressive therapy

Core Tip: Pancreas transplantation (PT) helps improve glycemic control in diabetic patients and is crucial for neurological recovery and endocrine regulation. Research shows that nerve regeneration, immunosuppressive therapy side effects, and long-term health management of transplant recipients are key factors influencing transplant outcomes. Analyzing literature and patents provides insights for clinical practice, and future research should focus on relevant mechanisms to improve long-term PT success.