用口服酸醇和类似物进行1型糖尿病的二次预防,PRECAL研究
Dimitrios T Papadimitriou1,2, Eleni Dermitzaki2, Panagiotis Christopoulos1
1Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Children (Basel, Switzerland)
|May 27, 2023
概括
在高风险儿童中,使用酸盐和酸盐可以预防1型糖尿病 (T1D) 的二次预防. 自体抗体阳性后的早期干预在预防或延迟T1D发病和实现缓解方面显示出希望.
科学领域:
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
- 儿科 儿科 儿科
背景情况:
- 1型糖尿病 (T1D) 查可以识别有风险的儿童,但缺乏有效的预防策略.
- 胆卡西醇已显示出降低T1D发病率的潜力,并且观察到酸可以消极T1D自身抗体.
- 需要进一步研究酸及其类似物酸对二次T1D预防的作用.
研究的目的:
- 调查酸盐和酸盐在高风险儿童中二次预防1型糖尿病 (T1D) 的疗效和安全性.
- 评估这些维生素D类型对T1D自身抗体状态,葡萄糖代谢和疾病进展的影响.
- 评估在新发型T1D患者中实现缓解的潜力.
主要方法:
- 一项前性,干预性,非随机临床试验 (PRECAL研究) 招募了50名高风险儿童 (T1Ab+,HLA易感).
- 参与者接受了口服卡尔西醇或帕里卡尔西醇以及胆卡尔西醇补充剂.
- 定期监测自身抗体 (T1Ab),葡萄糖代谢和代谢.
主要成果:
- 在没有T1D前/T1D的儿童中,T1Ab在0.57年内变为负值,或者他们没有发展T1D.
- 在T1D前的病例中,一个达到T1Ab阴性,一个没有进展,两个发展为T1D.
- 新发病的T1D患者经历了缓解 (6/9) 或立即进展 (3/9);复发患者在恢复治疗后重新否定了T1Ab.
结论:
- 二次性预防T1D似乎是可行的,用酸盐和酸盐,特别是当开始后的早期血清转化.
- 治疗证明了合理的安全性,具有可控的副作用,如过渡性高性尿/高血症.
- 维生素D类型在预防T1D发育,诱导缓解和恢复风险儿童自身抗体状况正常化方面表现有前途.
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