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1 型糖尿病的 CD4(+)CD25(high)CD127-regulatory T 细胞治疗可延长胰岛存活时间 - 一年随访结果。

Therapy of type 1 diabetes with CD4(+)CD25(high)CD127-regulatory T cells prolongs survival of pancreatic islets - results of one year follow-up.

机构信息

Department of Family Medicine, Medical University of Gdańsk, Dębinki 2, 80-210 Gdańsk, Poland.

Department of Pediatric Diabetology and Endocrinology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland.

出版信息

Clin Immunol. 2014 Jul;153(1):23-30. doi: 10.1016/j.clim.2014.03.016. Epub 2014 Apr 1.

Abstract

It is hypothesized that CD4(+)CD25(+)FoxP3(+) regulatory T cells (Tregs) can prevent destruction of pancreatic islets protecting from type 1 diabetes (DM1). Here we present results of one year follow-up of 12 DM1 children treated with autologous expanded ex vivo Tregs. Patients received either a single or double Tregs infusion up to the total dose of 30×10(6)/kg. No severe adverse effects were observed. The treatment did not impair post-immunization antibody responses. Tregs infusion was followed by increase in Tregs number in peripheral blood. Most of the patients responded to the therapy with increase in C-peptide levels (8/12 and 4/6 after the first and the second dose, respectively). Tregs administration resulted also in lower requirement for exogenous insulin (8/12 treated patients versus 2/10 untreated controls in remission) with two children completely insulin independent at one year. Repetitive administration of Tregs is safe and can prolong survival of β-cells in DM1 (registration: ISRCTN06128462).

摘要

研究假设 CD4(+)CD25(+)FoxP3(+)调节性 T 细胞(Tregs)可防止胰岛自身破坏,从而预防 1 型糖尿病(DM1)。本研究报告了 12 例接受自体扩增体外 Tregs 治疗的 DM1 患儿 1 年随访结果。患儿接受单次或双次 Tregs 输注,总量达 30×10(6)/kg。未观察到严重不良反应。治疗不影响免疫后抗体反应。Tregs 输注后外周血 Tregs 数量增加。大多数患者对治疗有反应,C 肽水平升高(第一次和第二次剂量后分别为 8/12 和 4/6)。Tregs 给药还导致对外源胰岛素的需求降低(缓解期 12 例治疗患者中 8/10 与 10 例未治疗对照相比),其中 2 例患儿在 1 年内完全无需胰岛素。重复给予 Tregs 是安全的,可以延长 DM1 患者β细胞的存活(注册号:ISRCTN06128462)。

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