School of Health Sciences, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
Department of Life Sciences, School of Pharmacy, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
Curr Diab Rep. 2019 Mar 23;19(5):22. doi: 10.1007/s11892-019-1144-3.
Type 1 diabetes (T1D) occurs when there is destruction of beta cells within the islets of Langerhans in the pancreas due to autoimmunity. It is considered a complex disease, and different complications can surface and worsen the condition if T1D is not managed well. Since it is an incurable disease, numerous treatments and therapies have been postulated in order to control T1D by balancing hyperglycemia control while minimizing hypoglycemic episodes. The purpose of this review is to primarily look into the current state of the available immunological therapies and their advantages for the treatment of T1D.
Over the years, immunological therapy has become the center of attraction to treat T1D. Immunomodulatory approaches on non-antigens involving agents such as cyclosporine A, mycophenolate mofetil, anti-CD20, cytotoxic T cells, anti-TNF, anti-CD3, and anti-thymocyte globulin as well as immunomodulative approaches on antigens such as insulin, glutamic acid decarboxylase, and heat shock protein 60 have been studied. Aside from these two approaches, studies and trials have also been conducted on regulatory T cells, dendritic cells, interleukin 2, interleukin 4, M2 macrophages, and rapamycin/interleukin 2 combination therapy to test their effects on patients with T1D. Many of these agents have successfully suppressed T1D in non-obese diabetic (NOD) mice and in human trials. However, some have shown negative results. To date, the insights into the management of the immune system have been increasing rapidly to search for potential therapies and treatments for T1D. Nevertheless, some of the challenges are still inevitable. A lot of work and effort need to be put into the investigation on T1D through immunological therapy, particularly to reduce complications to improve and enhance clinical outcomes.
1 型糖尿病（T1D）是由于自身免疫导致胰岛内β细胞破坏引起的。它被认为是一种复杂的疾病，如果 T1D 得不到很好的控制，不同的并发症可能会出现并使病情恶化。由于它是一种不可治愈的疾病，为了通过平衡高血糖控制的同时尽量减少低血糖发作来控制 T1D，已经提出了许多治疗和治疗方法。本文的目的主要是研究当前可用的免疫疗法及其在治疗 T1D 方面的优势。
多年来，免疫疗法已成为治疗 T1D 的焦点。涉及环孢素 A、霉酚酸酯、抗-CD20、细胞毒性 T 细胞、抗-TNF、抗-CD3 和抗胸腺细胞球蛋白等非抗原的免疫调节方法以及涉及胰岛素、谷氨酸脱羧酶和热休克蛋白 60 等抗原的免疫调节方法已被研究。除了这两种方法外，还对调节性 T 细胞、树突状细胞、白细胞介素 2、白细胞介素 4、M2 巨噬细胞和雷帕霉素/白细胞介素 2 联合治疗进行了研究，以测试它们对 T1D 患者的影响。许多这些药物已成功抑制非肥胖型糖尿病（NOD）小鼠和人类临床试验中的 T1D。然而，有些结果为阴性。迄今为止，对免疫系统管理的深入了解正在迅速增加，以寻找 T1D 的潜在治疗方法。然而，一些挑战仍然不可避免。需要投入大量的工作和努力来通过免疫疗法研究 T1D，特别是为了减少并发症以改善和增强临床结果。
