Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, E3-Q, P.O. Box 9600, NL-2300Rc, Leiden, The Netherlands.
Curr Diab Rep. 2013 Oct;13(5):704-12. doi: 10.1007/s11892-013-0399-3.
Type 1 diabetes (T1D) is an autoimmune disease in which the insulin-producing beta-cells are destroyed. Islet or pancreas transplantation can restore insulin secretion and are established therapies for subgroups of T1D patients. Long-term insulin-independence is, however, hampered by recurrent autoimmunity and rejection. Accurate monitoring of these immune events is therefore of critical relevance for the timely detection of deleterious immune responses. The identification of relevant immune biomarkers of allo- and autoreactivity has allowed a more accurate monitoring of disease progression and responses to therapy at early stages, allowing proper therapeutic intervention, and possibly improvements in the success rate of islet and pancreas transplantation. This review describes the tools established and validated to monitor immune correlates of auto- and alloreactivity that associate with clinical outcome and identifies challenges that current immunosuppression strategies trying to preserve islet graft function face.
1 型糖尿病（T1D）是一种自身免疫性疾病，其中产生胰岛素的β细胞被破坏。胰岛或胰腺移植可以恢复胰岛素分泌，是 T1D 患者亚组的既定治疗方法。然而，长期的胰岛素独立性受到反复发生的自身免疫和排斥的阻碍。因此，准确监测这些免疫事件对于及时发现有害免疫反应至关重要。鉴定与同种异体和自身反应相关的相关免疫生物标志物，允许在早期更准确地监测疾病进展和对治疗的反应，从而进行适当的治疗干预，并可能提高胰岛和胰腺移植的成功率。这篇综述描述了为监测与临床结果相关的自身和同种异体反应的免疫相关性而建立和验证的工具，并确定了当前试图保留胰岛移植物功能的免疫抑制策略所面临的挑战。
