预防儿童1型糖尿病
Colin M Dayan1,2, Rachel E J Besser3, Richard A Oram4
1Wellcome Centre for Human Genetics, Nuffield Department of Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Oxford, Oxford, UK. dayancm@cardiff.ac.uk.
概括
通过自身抗体和基因查早期发现1型糖尿病 (T1D) 可以识别有风险的儿童. 这允许进行干预以保护胰岛素产生细胞,从而可能消除每天注射胰岛素的需要.
科学领域:
- 免疫学
- 内分泌学
- 儿童医学
背景情况:
- 1型糖尿病 (T1D) 是一种自身免疫性疾病,胰腺β细胞被T淋巴细胞破坏.
- 目前的治疗重点是诊断后的胰岛素替代.
研究的目的:
- 转向早期诊断和维护β细胞.
- 探索预防或延迟儿童需要胰岛素治疗的可能性.
主要方法:
- 对胰岛素自身抗体进行监测.
- 对儿童的遗传风险评估.
- 评估用于T1D进展的二次预防的免疫治疗.
- 评估针对自身免疫过程的初级预防策略.
主要成果:
- 在显著的β细胞损失之前识别出大多数患T1D的儿童.
- 成功的二次预防试验延缓了疾病的进展.
- 主要预防试验已经进入大规模临床研究.
结论:
- 早期诊断和维护β细胞是改变T1D管理的关键.
- 对于患有T1D的儿童来说,预计未来将不再需要每天注射胰岛素.
- 积极的策略可以防止胰腺β细胞的自身免疫破坏.
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