Abram Débora Moitinho, Fernandes Luis Gustavo Romani, Ramos Filho Antônio Celso Saragossa, Simioni Patrícia Ucelli
Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil.
Department of Biomedical Science, Faculty of Americana, Americana, SP, Brazil.
Drug Des Devel Ther. 2017 Jul 24;11:2171-2178. doi: 10.2147/DDDT.S135367. eCollection 2017.
Diabetes mellitus type 1 (DM1) is an autoimmune disease in which β-cells of the pancreas islet are destroyed by T lymphocytes. Specific T cells are activated by antigen-presenting cells, mainly dendritic cells (DCs). It is already known that the regulation of tryptophan pathway in DC can be a mechanism of immunomodulation. The enzyme indoleamine 2,3-dioxygenase (IDO) is present in many cells, including DC, and participates in the metabolism of the amino acid tryptophan. Recent studies suggest the involvement of IDO in the modulation of immune response, which became more evident after the in vitro demonstration of IDO production by DC and of the ability of these cells to inhibit lymphocyte function through the control of tryptophan metabolism. Current studies on immunotherapies describe the use of DC and IDO to control the progression of the immune response that triggers DM1. The initial results obtained are promising and indicate the possibility of developing therapies for the treatment or prevention of the DM1. Clinical trials using these cells in DM1 patients represent an interesting alternative treatment. However, clinical trials are still in the initial phase and a robust group of assays is necessary.
1型糖尿病(DM1)是一种自身免疫性疾病,其中胰岛的β细胞被T淋巴细胞破坏。特定的T细胞由抗原呈递细胞(主要是树突状细胞,即DCs)激活。已知DC中色氨酸途径的调节可能是一种免疫调节机制。吲哚胺2,3-双加氧酶(IDO)存在于包括DC在内的许多细胞中,并参与氨基酸色氨酸的代谢。最近的研究表明IDO参与免疫反应的调节,这在体外证明DC产生IDO以及这些细胞通过控制色氨酸代谢抑制淋巴细胞功能后变得更加明显。目前关于免疫疗法的研究描述了使用DC和IDO来控制引发DM1的免疫反应的进展。获得的初步结果很有前景,并表明开发治疗或预防DM1的疗法是可能的。在DM1患者中使用这些细胞的临床试验是一种有趣的替代治疗方法。然而,临床试验仍处于初始阶段,需要进行大量的试验。