a Department of Medicine 'B' , Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center , Tel-Hashomer , Israel.
b Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
Expert Rev Clin Immunol. 2018 Dec;14(12):1081-1088. doi: 10.1080/1744666X.2018.1538787. Epub 2018 Oct 24.
Type 1 diabetes mellitus (T1DM) is a chronic disease characterized by the destruction of insulin-producing β-cells of the pancreas. The current paradigm in this disease's etiopathogenesis points toward the interplay of genetic and environmental factors. Among the environmental variables, dietary factors, intestinal microbiota, toxins, and psychological stress have been implicated in disease onset. Areas covered: This review aims to investigate the relationship between psychological stress and T1DM by presenting evidence from epidemiological studies, animal models, and to provide the mechanism involved in this association. The literature search was conducted through PubMed to identify studies that investigate the connection between stress and T1DM. Experimental designs, such as case-control, and retrospective and prospective cohorts studies, were included. Expert commentary: A wide array of evidence, ranging from epidemiological to animal models, points toward the role of psychological stressors in T1DM pathogenesis. Various mechanisms have been proposed, including the hypothalamic-pituitary-adrenal (HPA) axis, influence of the nervous system on immune cells, and insulin resistance. Further research could investigate the gene-stress interactions to evaluate the risk of T1DM development.
1 型糖尿病（T1DM）是一种慢性疾病，其特征是胰腺产生胰岛素的β细胞遭到破坏。目前，该疾病发病机制的研究模式主要集中在遗传和环境因素的相互作用上。在环境变量中，饮食因素、肠道微生物群、毒素和心理压力被认为与疾病的发生有关。
本综述旨在通过展示来自流行病学研究、动物模型的证据，探讨心理压力与 T1DM 之间的关系，并提供该关联涉及的机制。通过 PubMed 进行文献检索，以确定研究压力与 T1DM 之间联系的研究。包括病例对照、回顾性和前瞻性队列研究等实验设计。
从流行病学到动物模型的大量证据表明，心理应激在 T1DM 发病机制中起作用。已经提出了各种机制，包括下丘脑-垂体-肾上腺（HPA）轴、神经系统对免疫细胞的影响以及胰岛素抵抗。进一步的研究可以探讨基因-压力相互作用，以评估 T1DM 发展的风险。
