Hanley Stephen
Mcgill J Med. 2009 Nov 16;12(2):51.
While the prevalence of maternal While the prevalence of diabetes mellitus reaches epidemic proportions, most available treatments still focus on the symptoms of the disease, rather than the underlying pathology. Types 1 and 2 diabetes have in common a deficit in β-cell mass. In type 1 diabetes, auto-immune β-cell destruction leads to an absolute deficit in β-cells, while in type 2 diabetes, insulin resistance and β-cell dysfunction cause a functional deficit. More recently, however, it has been suggested that type 2 diabetes is also marked by an absolute deficit in β-cell mass, although a causal relationship has not yet been established. Overall β-cell mass reflects the balance between the dynamic processes of β-cell expansion, through proliferation and neogenesis, and β-cell loss via apoptosis. Given that β-cell mass can be modified significantly by altering the rate of any of these mechanisms, therapies that modulate β-cell expansion and loss have garnered recent interest. We review herein the current therapeutics under investigation as modulators of β-cell mass dynamics, and the basic research that supports these novel therapeutic targets.
尽管糖尿病在孕妇中的患病率已达到流行程度，但大多数现有治疗方法仍侧重于该疾病的症状，而非潜在的病理机制。1型和2型糖尿病的共同之处在于β细胞数量不足。在1型糖尿病中，自身免疫性β细胞破坏导致β细胞绝对缺乏，而在2型糖尿病中，胰岛素抵抗和β细胞功能障碍导致功能性缺乏。然而，最近有研究表明，2型糖尿病也存在β细胞数量绝对不足的情况，尽管尚未建立因果关系。总体而言，β细胞数量反映了β细胞通过增殖和新生实现扩张的动态过程与通过凋亡导致β细胞丢失之间的平衡。鉴于通过改变这些机制中的任何一种的速率都可以显著改变β细胞数量，调节β细胞扩张和丢失的疗法最近引起了人们的关注。我们在此综述目前正在研究的作为β细胞数量动态调节剂的治疗方法，以及支持这些新型治疗靶点的基础研究。
