Pediatrics Epidemiology Center, Morsani College of Medicine, University of South Florida, 3650 Spectrum Blvd, Ste 100, Tampa, FL, 33612, USA,
Curr Diab Rep. 2013 Oct;13(5):642-50. doi: 10.1007/s11892-013-0406-8.
Type 1 diabetes (T1D) research has made great strides over the past decade with advances in understanding the pathogenesis, natural history, candidate environmental exposures, exposure triggering time, disease prediction, and diagnosis. Major monitoring efforts have provided baseline historical measures, leading to better epidemiological studies incorporating longitudinal biosamples (ie, biobanks), which have allowed for new technologies ('omics') to further expose the etiological agents responsible for the initiation, progression, and eventual clinical onset of T1D. These new frontiers have brought forth high-dimensionality data, which have furthered the evidence of the heterogeneous nature of T1D pathogenesis and allowed for a more mechanistic approach in understanding the etiology of T1D. This review will expand on the most recent advances in the quest for T1D determinants, drawing upon novel research tools that epidemiology, genetics, microbiology, and immunology have provided, linking them to the major hypotheses associated with T1D etiology, and discussing the future frontiers.
在过去的十年中，随着对发病机制、自然史、候选环境暴露、暴露触发时间、疾病预测和诊断的深入理解，1 型糖尿病（T1D）的研究取得了重大进展。主要的监测工作提供了基线历史数据，从而使纳入纵向生物样本（即生物库）的流行病学研究更加完善，这也为新技术（组学）提供了条件，进一步揭示了导致 T1D 发生、进展和最终临床发作的病因。这些新的前沿领域带来了高维度的数据，进一步证明了 T1D 发病机制的异质性，并为理解 T1D 的病因提供了更具机制性的方法。本综述将扩展 T1D 决定因素的最新进展，借鉴流行病学、遗传学、微生物学和免疫学提供的新研究工具，将其与与 T1D 病因相关的主要假设联系起来，并讨论未来的前沿领域。
