Biochemistry Area, Health Science Department, Faculty of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain.
Diabetes research group at Sanford Research, Sioux Falls, SD 57104, USA.
Int J Mol Sci. 2019 Sep 26;20(19):4789. doi: 10.3390/ijms20194789.
Type 1 diabetes mellitus (T1D) is an autoimmune illness that affects millions of patients worldwide. The main characteristic of this disease is the destruction of pancreatic insulin-producing beta cells that occurs due to the aberrant activation of different immune effector cells. Currently, T1D is treated by lifelong administration of novel versions of insulin that have been developed recently; however, new approaches that could address the underlying mechanisms responsible for beta cell destruction have been extensively investigated. The strategies based on immunotherapies have recently been incorporated into a panel of existing treatments for T1D, in order to block T-cell responses against beta cell antigens that are very common during the onset and development of T1D. However, a complete preservation of beta cell mass as well as insulin independency is still elusive. As a result, there is no existing T1D targeted immunotherapy able to replace standard insulin administration. Presently, a number of novel therapy strategies are pursuing the goals of beta cell protection and normoglycemia. In the present review we explore the current state of immunotherapy in T1D by highlighting the most important studies in this field, and envision novel strategies that could be used to treat T1D in the future.
1 型糖尿病(T1D)是一种影响全球数百万人的自身免疫性疾病。这种疾病的主要特征是由于不同免疫效应细胞的异常激活而导致胰腺产生胰岛素的β细胞被破坏。目前,T1D 的治疗方法是通过终身使用最近开发的新型胰岛素;然而,人们已经广泛研究了能够针对导致β细胞破坏的潜在机制的新方法。基于免疫疗法的策略最近已被纳入 T1D 的现有治疗方案中,以阻止 T 细胞对 T1D 发病和发展过程中非常常见的β细胞抗原的反应。然而,β细胞质量的完全保留以及胰岛素的独立性仍然难以实现。因此,目前尚无针对 T1D 的现有免疫疗法能够替代标准胰岛素治疗。目前,许多新的治疗策略都在追求β细胞保护和血糖正常化的目标。在本综述中,我们通过强调该领域最重要的研究来探讨 T1D 中的免疫疗法现状,并设想未来可能用于治疗 T1D 的新策略。