Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Research Center of Molecular Immunology, Tehran University of Medical Sciences, Tehran, Iran.
Endocr Metab Immune Disord Drug Targets. 2022;22(2):169-197. doi: 10.2174/1871530321666210203212809.
Type 1 Diabetes (T1D) is a complex autoimmune disorder which occurs as a result of an intricate series of pathologic interactions between pancreatic β-cells and a wide range of components of both the innate and the adaptive immune systems. Stem-cell therapy, a recently-emerged potentially therapeutic option for curative treatment of diabetes, is demonstrated to cause significant alternations to both different immune cells such as macrophages, natural killer (NK) cells, dendritic cells, T cells, and B cells and non-cellular elements, including serum cytokines and different components of the complement system. Although there exists overwhelming evidence indicating that the documented therapeutic effects of stem cells on patients with T1D are primarily due to their potential for immune regulation rather than pancreatic tissue regeneration, to date, the precise underlying mechanisms remain obscure. On the other hand, immune-mediated rejection of stem cells remains one of the main obstacles to regenerative medicine. Moreover, the consequences of efferocytosis of stem-cells by the recipients' lung-resident macrophages have recently emerged as a mechanism responsible for some immune-mediated therapeutic effects of stem-cells. This review focuses on the nature of the interactions amongst different compartments of the immune systems which are involved in the pathogenesis of T1D and provides an explanation as to how stem cell- based interventions can influence immune system and maintain the physiologic equilibrium.
1 型糖尿病（T1D）是一种复杂的自身免疫性疾病，是由于胰腺β细胞与固有和适应性免疫系统的广泛成分之间一系列复杂的病理相互作用而发生的。干细胞治疗是一种新兴的潜在治疗糖尿病的方法，被证明会导致不同免疫细胞（如巨噬细胞、自然杀伤（NK）细胞、树突状细胞、T 细胞和 B 细胞）和非细胞成分（包括血清细胞因子和补体系统的不同成分）发生显著变化。尽管有压倒性的证据表明，干细胞对 T1D 患者的有记载的治疗效果主要归因于其免疫调节潜力，而不是胰腺组织再生，但迄今为止，确切的潜在机制仍不清楚。另一方面，免疫介导的干细胞排斥仍然是再生医学的主要障碍之一。此外，最近发现，受者肺驻留巨噬细胞对干细胞的吞噬作用的后果是导致干细胞的一些免疫介导治疗效果的机制之一。这篇综述重点介绍了参与 T1D 发病机制的免疫系统不同部位之间的相互作用的性质，并解释了基于干细胞的干预措施如何影响免疫系统并维持生理平衡。
