在1型糖尿病中持久替代β细胞的策略
Todd M Brusko1,2, Holger A Russ3, Cherie L Stabler4
1Department of Pathology, Immunology and Laboratory Medicine, and Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
概括
新的干细胞疗法和免疫调节疗法旨在恢复1型糖尿病患者的天然葡萄糖调节,提供超越目前监测和胰岛素输送的途径. 这些进步的目标是持久的β细胞替代和预防免疫排斥.
科学领域:
- 内分泌学和新陈代谢
- 复原医学
- 免疫学
背景情况:
- 目前的血糖监测和胰岛素疗法可以改善1型糖尿病患者的生活质量,但不能完全复制原生胰岛功能.
- 恢复内源性葡萄糖调节仍然是T1D管理的关键挑战.
研究的目的:
- 检查小岛细胞替代和T1D免疫调节疗法的综合进展.
- 突出恢复β细胞功能和防止免疫媒介破坏的创新方法.
主要方法:
- 对产生胰岛素的干细胞生物学近期进展的回顾.
- 对改善细胞移植和功能的新型移植部位设计的分析.
- 探索最先进的免疫调节策略,以防止异种移植排斥和自身免疫性复发.
主要成果:
- 干细胞来源和生物材料的进步为β细胞的替代提供了新的途径.
- 改进的移植策略增加了功能性小岛细胞移植的可能性.
- 新兴的免疫调节方法有望克服长期移植生存的障碍.
结论:
- 结合干细胞衍生小岛和先进免疫调节的综合策略对于持久的T1D治疗至关重要.
- 更深入地了解T1D病因,β细胞生物学和生物材料科学正在推动治疗创新.
- 这些进步具有很大的潜力,可以长期替代被破坏的β细胞,并恢复1型糖尿病的代谢控制.
相关概念视频
Tissue Renewal without Stem Cells
1.9K
After cellular or tissue damage, the resident stem cells present in the human body can locally repair and regenerate the damaged tissue or organ. However, even though some tissues do not have stem cells, they can repair and regenerate with the help of pre-existing cells. For example, beta cells of the pancreas and hepatocytes of the liver can divide to renew and regenerate the tissue. Here, both cell division and cell death are well regulated by homeostasis.
However, failure of such a system...
However, failure of such a system...
1.9K
Insulin: Biosynthesis, Chemistry, and Preparation
700
The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
700
Carbohydrate Metabolism
12.7K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
12.7K
Diabetes: Management and Pharmacotherapy
595
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
595
Diabetes Mellitus: Overview and Type I Subtype
4.0K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
4.0K
Insulin: Dosing Regimen and Adverse Effects
329
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
329


