Institute for Clinical Diabetology, German Diabetes Center, Leibniz-Center for Diabetes Research, Heinrich-Heine University, Düsseldorf, Germany.
Clin Immunol. 2013 Dec;149(3):307-16. doi: 10.1016/j.clim.2013.09.001. Epub 2013 Sep 11.
Type 1 diabetes is a chronic immune-mediated disease resulting in destruction of insulin-producing β-cells. Several studies have been performed aiming to halt disease progression after diagnosis; to reduce the increased diabetes risk in islet-autoantibody positive subjects; and to prevent the onset of β-cell autoimmunity in subjects genetically at risk but without autoantibodies. Whereas secondary prevention trials failed, trials in newly diagnosed patients have shown partial success in preserving C-peptide. These studies target T-cells and inflammation and make use of antigen-specific immune modulation or stem cell approaches. However, thus far no immune-based therapeutic regimen has cured type 1 diabetes after its clinical onset or has stabilized the decline of C-peptide to achieve the status of an approved drug. This review summarizes immune intervention trials and the current knowledge of DiaPep277® peptide as a form of immune intervention in type 1 diabetes.
1 型糖尿病是一种慢性免疫介导的疾病,导致胰岛素产生β细胞的破坏。已经进行了多项研究,旨在诊断后阻止疾病进展;降低胰岛自身抗体阳性受试者的糖尿病风险增加;并预防遗传易感但无自身抗体的受试者发生β细胞自身免疫。虽然二级预防试验失败,但新诊断患者的试验表明,在保留 C 肽方面取得了部分成功。这些研究针对 T 细胞和炎症,并利用抗原特异性免疫调节或干细胞方法。然而,迄今为止,在 1 型糖尿病临床发病后,没有任何基于免疫的治疗方案能够治愈该疾病,也没有稳定 C 肽的下降,从而达到批准药物的地位。本综述总结了免疫干预试验以及 DiaPep277®肽作为 1 型糖尿病免疫干预形式的最新知识。