Molecular Development of the Immune System Section, Laboratory of Immunology, NIAID Clinical Genomics Program, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
Clin Immunol. 2015 Feb;156(2):109-18. doi: 10.1016/j.clim.2014.11.007. Epub 2014 Dec 5.
Type 1 diabetes is a progressive autoimmune disease with no curative treatment, making prevention critical. At the time of diagnosis, a majority of the insulin secreting β-cells have already been destroyed. Insulitis, lymphocytic infiltration to the pancreatic islets, is believed to begin months to years before the clinical symptoms of insulin deficiency appear. Insulitis should be treated as its own disease, for it is a known precursor to autoimmune diabetes. Because it is difficult to detect insulitic cellular infiltrates noninvasively, considerable interest has been focused on the levels of islet autoantibodies in blood as measurable diagnostic markers for islet autoimmunity. The traditional islet autoantibody detection assays have many limitations. New electrochemiluminescence-based autoantibody detection assays have the potential to overcome these challenges and they offer promising, cost-effective screening tools in identifying high-risk individuals for trials of preventive interventions. Here, we outline diagnostic and therapeutic strategies to overcome pancreatic β-cell destroying insulitis.
1 型糖尿病是一种进行性自身免疫性疾病，目前尚无治愈方法，因此预防至关重要。在诊断时，大部分胰岛素分泌β细胞已经被破坏。人们认为，在出现胰岛素缺乏的临床症状之前，数月甚至数年前就已经发生了胰岛自身免疫性炎症（胰岛炎），即淋巴细胞浸润胰岛。胰岛炎应被视为自身疾病，因为它是众所周知的自身免疫性糖尿病的前期病变。由于难以非侵入性地检测胰岛炎细胞浸润，因此人们对血液中胰岛自身抗体的水平作为胰岛自身免疫的可测量诊断标志物产生了浓厚的兴趣。传统的胰岛自身抗体检测方法存在许多局限性。新型基于电化学发光的自身抗体检测方法有可能克服这些挑战，并为高危人群提供有前景且具有成本效益的筛选工具，以确定进行预防干预试验的对象。在这里，我们概述了克服胰腺β细胞破坏的胰岛炎的诊断和治疗策略。
