Department of Physiology and Pathophysiology, School of Basic Medical Sciences Peking University Health Science Center, Key Laboratory of Cardiovascular Science of the Ministry of Education, Center for Non-coding RNA Medicine, Beijing 100191, China.
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China.
Adv Drug Deliv Rev. 2019 Jan 15;139:32-50. doi: 10.1016/j.addr.2018.11.007. Epub 2018 Dec 5.
Diabetes is a chronic non-communicable disease affecting over 400 million people worldwide. Diabetic patients are at a high risk of various complications, such as cardiovascular, renal, and other diseases. The pathogenesis of diabetes (both type 1 and type 2 diabetes) is associated with a functional impairment of pancreatic β-cells. Consequently, most efforts to manage and prevent diabetes have focused on preserving β-cells and their function. Advances in imaging techniques, such as magnetic resonance imaging, magnetic resonance spectroscopy, positron emission tomography, and single-photon-emission computed tomography, have enabled noninvasive and quantitative detection and characterization of the population and function of β-cells in vivo. These advantages aid in defining and monitoring the progress of diabetes and determining the efficacy of anti-diabetic therapies. Beyond β-cell targeting, molecular imaging of biomarkers associated with the development of diabetes, e.g., lymphocyte infiltration, insulitis, and metabolic changes, may also be a promising strategy for early detection of diabetes, monitoring its progression, and occurrence of complications, as well as facilitating exploration of new therapeutic interventions. Moreover, molecular imaging of glucose uptake, production and excretion in specified tissues is critical for understanding the pathogenesis of diabetes. In the current review, we summarize and discuss recent advances in noninvasive imaging technologies for imaging of biomarkers beyond β-cells for early diagnosis of diabetes, investigation of glucose metabolism, and precise diagnosis and monitoring of diabetic complications for better management of diabetic patients.
糖尿病是一种影响全球超过 4 亿人的慢性非传染性疾病。糖尿病患者存在多种并发症的高风险，如心血管、肾脏等疾病。糖尿病（1 型和 2 型糖尿病）的发病机制与胰腺β细胞的功能障碍有关。因此，大多数管理和预防糖尿病的努力都集中在保护β细胞及其功能上。成像技术的进步，如磁共振成像、磁共振波谱、正电子发射断层扫描和单光子发射计算机断层扫描，使β细胞及其功能的体内群体和功能的无创和定量检测和特征成为可能。这些优势有助于定义和监测糖尿病的进展，并确定抗糖尿病疗法的疗效。除了β细胞靶向外，与糖尿病发展相关的生物标志物的分子成像，如淋巴细胞浸润、胰岛炎和代谢变化，也可能是早期发现糖尿病、监测其进展和并发症发生以及促进新的治疗干预措施探索的有前途的策略。此外，特定组织中葡萄糖摄取、产生和排泄的分子成像对于了解糖尿病的发病机制至关重要。在本综述中，我们总结和讨论了用于早期诊断糖尿病、研究葡萄糖代谢以及精确诊断和监测糖尿病并发症的无创成像技术在成像β细胞以外的生物标志物方面的最新进展，以便更好地管理糖尿病患者。
