Graf S, Schumm-Draeger P-M
Klinik für Endokrinologie, Diabetologie und Angiologie, Städt. Kliniken München GmbH, Klinikum Bogenhausen, München.
Z Rheumatol. 2011 Nov;70(9):747-51. doi: 10.1007/s00393-011-0795-5.
New studies have demonstrated similarities in the complex pathomechanisms of diabetes mellitus type 1 (T₁D) and rheumatic diseases and in particular rheumatoid arthritis (RA). Common HLA gene complex characteristics and polymorphisms of inflammatory cytokines, such as interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) play a special role in both disorders. The metabolic syndrome, associated with insulin resistance and diabetes mellitus type 2 (T₂D), often shows criteria of a subclinical chronic inflammation. New forms of therapy with monoclonal antibodies against TNF-α, IL-1 and IL-6 have improved the management of patients with RA. Cytokine-induced inflammation also seems to be important in the pathogenesis and progression of T₁D and T₂D. Whether a therapy with the same monoclonal antibodies established in RA could also be successful in diabetes still has to be investigated in further studies. Both RA and T₁D are autoimmune disorders and show a cumulative incidence with further autoimmune diseases.
新的研究表明,1型糖尿病(T₁D)和风湿性疾病,尤其是类风湿关节炎(RA),在复杂的发病机制上存在相似之处。常见的人类白细胞抗原(HLA)基因复合体特征以及炎性细胞因子的多态性,如白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α),在这两种疾病中都起着特殊作用。与胰岛素抵抗和2型糖尿病(T₂D)相关的代谢综合征,常常表现出亚临床慢性炎症的标准。针对TNF-α、IL-1和IL-6的单克隆抗体的新型治疗方法改善了RA患者的治疗管理。细胞因子诱导的炎症在T₁D和T₂D的发病机制及进展中似乎也很重要。在RA中已确立的相同单克隆抗体治疗方法在糖尿病中是否也能取得成功,仍有待进一步研究。RA和T₁D都是自身免疫性疾病,并且与其他自身免疫性疾病的累积发病率相关。