Couri Carlos Eduardo Barra, Voltarelli Júlio César
Department of Clinical Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Arq Bras Endocrinol Metabol. 2008 Mar;52(2):407-15. doi: 10.1590/s0004-27302008000200029.
Type 1 diabetes mellitus is the result of the autoimmune response against pancreatic beta-cell(s). At the time of clinical diagnosis near 70% of beta-cell mass is been destroyed as a consequence of the auto-destruction that begins months or even years before the clinical diagnosis. Although marked reduction of chronic complications was seen after development and progression of insulin therapy over the years for type 1 diabetic population, associated risks of chronic end-organ damage and hypoglycemia still remain. Besides tight glucose control, beta-cell mass preservation and/or increase are known to be other important targets in management of type 1 diabetes as long as it reduces chronic microvascular complications in the eyes, kidneys and nerves. Moreover, the larger the beta-cell mass, the lower the incidence of hypoglycemic events. In this article, we discuss some insights about beta-cell regeneration, the importance of regulation of the autoimmune process and what is being employed in human type 1 diabetes in regard to stem cell repertoire to promote regeneration and/or preservation of beta-cell mass.
1型糖尿病是针对胰腺β细胞的自身免疫反应的结果。在临床诊断时,由于在临床诊断前数月甚至数年就开始的自我破坏,近70%的β细胞团已被破坏。尽管多年来胰岛素治疗在1型糖尿病患者中发展和进步后,慢性并发症有显著减少,但慢性终末器官损伤和低血糖的相关风险仍然存在。除了严格控制血糖外,β细胞团的保存和/或增加是1型糖尿病管理中的其他重要目标,因为这可以减少眼睛、肾脏和神经的慢性微血管并发症。此外,β细胞团越大,低血糖事件的发生率越低。在本文中,我们讨论了一些关于β细胞再生的见解、自身免疫过程调节的重要性,以及在人类1型糖尿病中关于干细胞储备方面为促进β细胞团的再生和/或保存所采用的方法。