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1型糖尿病:发病机制与治疗的最新进展

[Type 1 diabetes mellitus: most recent advances in its pathogenesis and treatment].

作者信息

Zóka András, Somogyi Anikó, Firneisz Gábor

机构信息

Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest.

出版信息

Orv Hetil. 2012 Jul 8;153(27):1047-56. doi: 10.1556/OH.2012.29413.

Abstract

The incidence and prevalence of diabetes mellitus is globally increasing. The causes of this trend are relatively obvious in the case of type 2 diabetes. In contrast, in case of type 1 diabetes the amount of available data is continuously growing, but the causes are not so well defined. The genetic risk, especially related to the MHC genes is well known, and the increasing amount of data underlines the role of additional risks due to non-MHC genetic polimorphisms. Hopefully, they will provide the basis for future diagnostic and therapeutic approaches. There is increasing knowledge about the pathophysiological aspects including the role of immunological disregulation (balance of autotolerance, role of regulatory T-cells) and environmental triggers (nutrients, viruses). Information on the entero-insular axis and the β-cell protective role of incretin hormones might offer an opportunity for new therapeutic strategies. In this paper, the authors try to summarize some current aspects of the pathomechanism and related therapeutic approaches.

摘要

糖尿病的发病率和患病率在全球范围内都在上升。在2型糖尿病的情况下,这种趋势的原因相对明显。相比之下,对于1型糖尿病,可用数据的数量在不断增加,但其病因尚不明确。遗传风险,尤其是与MHC基因相关的风险是众所周知的,越来越多的数据强调了非MHC基因多态性带来的额外风险的作用。有望它们将为未来的诊断和治疗方法提供基础。关于病理生理学方面的知识越来越多,包括免疫调节紊乱(自身耐受性平衡、调节性T细胞的作用)和环境触发因素(营养物质、病毒)的作用。关于肠-胰岛轴和肠促胰岛素激素对β细胞的保护作用的信息可能为新的治疗策略提供机会。在本文中,作者试图总结发病机制和相关治疗方法的一些当前方面。

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