Maclaren N K, Riley W J, Winter W E, Silverstein J H
Department of Pathology, University of Florida, Gainesville 32610.
Clin Invest Med. 1987 Sep;10(5):444-9.
Despite improvements in the ongoing care of individuals with insulin-dependent diabetes, the disease continues to produce significant morbidity and mortality, especially early in life, in individuals developing insulin-dependent diabetes in childhood or adolescence. In order to have a major impact on disease outcome, the best therapeutic approach is disease prevention. Because insulin-dependent diabetes results from autoimmune pancreatic beta cell destruction, the disease may be amenable to immunological intervention with immunotherapy. This is particularly exciting as we develop tools, such as islet cell autoantibody determinations, that allow diagnosis of individuals prior to clinical presentation. It is during this time-period when immune manipulation may be most efficacious in preventing further beta cell destruction, and otherwise eventual insulin dependence. As such trials are highly experimental, they must be conducted only in research centers staffed by physicians and scientists with expertise in diabetes, autoimmunity, and immunology.
尽管在胰岛素依赖型糖尿病患者的持续护理方面有所改善，但该疾病仍会导致显著的发病率和死亡率，尤其是在儿童期或青春期患胰岛素依赖型糖尿病的个体中，在生命早期更是如此。为了对疾病结局产生重大影响，最佳治疗方法是疾病预防。由于胰岛素依赖型糖尿病是由自身免疫性胰腺β细胞破坏引起的，该疾病可能适合通过免疫疗法进行免疫干预。随着我们开发诸如胰岛细胞自身抗体测定等工具，能够在临床症状出现之前诊断个体，这尤其令人兴奋。正是在这个时间段，免疫操纵在预防进一步的β细胞破坏以及最终预防胰岛素依赖方面可能最为有效。由于此类试验具有高度的实验性，因此必须仅在由具有糖尿病、自身免疫和免疫学专业知识的医生和科学家组成的研究中心进行。
