自身抗体阴性 1 型糖尿病：一种被忽视的亚型。
Autoantibody-Negative Type 1 Diabetes: A Neglected Subtype.
机构信息
Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, NSW, Australia; Department of Diabetes and Endocrinology, St. Vincent's Hospital, Sydney, NSW, Australia; St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia; Human Immune Disorders, Garvan Institute of Medical Research, Sydney, NSW, Australia.
出版信息
Trends Endocrinol Metab. 2021 May;32(5):295-305. doi: 10.1016/j.tem.2021.02.001. Epub 2021 Mar 9.
Up to 15% of individuals with a clinical phenotype of type 1 diabetes (T1D) do not have evidence of seropositivity for pancreatic islet autoantibodies. On this basis, they are classified as nonimmune or idiopathic, and remain an understudied population, as they are excluded from T1D immunomodulatory trials. Our limited understanding of the disease aetiopathogenesis in autoantibody-negative T1D hinders our ability to improve diagnostic pathways and discover novel therapeutic agents; particularly as we progress towards an era of precision medicine. This review summarises the current understanding and challenges in studying autoantibody-negative T1D. We review the literature regarding T1D classification, and the role of autoimmunity and defects in the immunogenic pathway that may distinguish autoantibody-positive and -negative T1D.
高达 15%的具有 1 型糖尿病（T1D）临床表型的个体没有胰岛自身抗体的血清阳性证据。在此基础上，他们被归类为非免疫或特发性，并且仍然是一个研究不足的人群，因为他们被排除在 T1D 免疫调节试验之外。我们对自身抗体阴性 T1D 疾病发病机制的有限了解阻碍了我们改善诊断途径和发现新的治疗药物的能力；特别是当我们迈向精准医学时代时。这篇综述总结了目前对自身抗体阴性 T1D 的研究的理解和挑战。我们回顾了有关 T1D 分类的文献，以及自身免疫和免疫原性途径缺陷的作用，这些可能区分自身抗体阳性和阴性 T1D。
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