Rewers Marian, Ludvigsson Johnny
Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO, USA.
Division of Pediatrics, Department of Clinical and Experimental Medicine, Medical Faculty, Linköping University and Linköping University Hospital, Linköping, Sweden.
Lancet. 2016 Jun 4;387(10035):2340-2348. doi: 10.1016/S0140-6736(16)30507-4.
The incidence of type 1 diabetes has risen considerably in the past 30 years due to changes in the environment that have been only partially identified. In this Series paper, we critically discuss candidate triggers of islet autoimmunity and factors thought to promote progression from autoimmunity to overt type 1 diabetes. We revisit previously proposed hypotheses to explain the growth in the incidence of type 1 diabetes in light of current data. Finally, we suggest a unified model in which immune tolerance to β cells can be broken by several environmental exposures that induce generation of hybrid peptides acting as neoautoantigens.
在过去30年里，由于环境变化（但仅部分被识别），1型糖尿病的发病率显著上升。在本系列论文中，我们批判性地讨论了胰岛自身免疫的候选触发因素以及被认为促进从自身免疫发展为显性1型糖尿病的因素。我们根据当前数据重新审视了先前提出的用以解释1型糖尿病发病率增长的假说。最后，我们提出了一个统一模型，在该模型中，对β细胞的免疫耐受可被几种环境暴露打破，这些暴露诱导产生充当新自身抗原的杂合肽。
