Woittiez Nicky J C, Roep Bart O
Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, E3-Q, LUMC, PO Box 9600, NL-2300RC Leiden, The Netherlands.
Immunotherapy. 2015;7(2):163-74. doi: 10.2217/imt.14.104.
Type 1 diabetes results from selective destruction of insulin-producing pancreatic β-cells by a progressive autoimmune process. Type 1 diabetes proves very heterogeneous in pathology, disease progression and efficacy of therapeutic intervention. Indeed, several immunotherapies that appear ineffective for the entire treated patient population in fact look promising in subgroups of patients. It therefore seems inconceivable that one standard therapy will provide the golden bullet of disease intervention. Instead, personalized medicine may improve immune intervention efficacy rates. We discuss the effect of disease heterogeneity on treatment outcome of immunotherapies, identifying apparent gaps in our understanding of treatment efficacy in subgroups of Type 1 diabetic patients as well as identifying future opportunities for immunotherapy.
1型糖尿病是由一种进行性自身免疫过程选择性破坏产生胰岛素的胰腺β细胞所致。1型糖尿病在病理学、疾病进展和治疗干预效果方面表现出很大的异质性。事实上，几种对整个治疗患者群体似乎无效的免疫疗法，在部分患者亚组中却显示出了前景。因此，一种标准疗法能成为疾病干预的万灵药似乎是不可思议的。相反，个性化医疗可能会提高免疫干预的有效率。我们讨论了疾病异质性对免疫疗法治疗结果的影响，明确了我们在理解1型糖尿病患者亚组治疗效果方面存在的明显差距，同时也确定了免疫疗法未来的机遇。
