Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy.
International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università di Milano, Milan, Italy.
Front Immunol. 2021 Jul 9;12:694118. doi: 10.3389/fimmu.2021.694118. eCollection 2021.
Despite the increasing knowledge of pathophysiological mechanisms underlying the onset of type 1 diabetes (T1D), the quest for therapeutic options capable of delaying/reverting the diseases is still ongoing. Among all strategies currently tested in T1D, the use of hematopoietic stem cell (HSC)-based approaches and of teplizumab, showed the most encouraging results. Few clinical trials have already demonstrated the beneficial effects of HSCs in T1D, while the durability of the effect is yet to be established. Investigators are also trying to understand whether the use of selected and better-characterized HSCs subsets may provide more benefits with less risks. Interestingly, manipulated HSCs showed promising results in murine models and the recent introduction of the humanized mouse models accelerated the translational potentials of such studies and their final road to clinic. Indeed, immunomodulatory as well as trafficking abilities can be enhanced in genetically modulated HSCs and genetically engineered HSCs may be viewed as a novel "biologic" therapy, to be further tested and explored in T1D and in other autoimmune/immune-related disorders.
尽管人们对 1 型糖尿病 (T1D) 发病的病理生理机制有了越来越多的了解,但寻求能够延缓/逆转该疾病的治疗方法的研究仍在继续。在目前所有在 T1D 中测试的策略中,基于造血干细胞 (HSC) 的方法和 teplizumab 的使用显示出最有希望的结果。少数临床试验已经证明了 HSCs 在 T1D 中的有益作用,而其效果的持久性仍有待确定。研究人员还试图了解使用选定的和特征更好的 HSC 亚群是否可能带来更多的益处,同时风险更小。有趣的是,经过改造的 HSCs 在小鼠模型中显示出有前景的结果,而最近引入的人源化小鼠模型加速了这些研究的转化潜力及其最终进入临床的进程。事实上,经过基因修饰的 HSCs 可以增强其免疫调节和归巢能力,而经过基因工程改造的 HSCs 可以被视为一种新的“生物”疗法,将在 T1D 和其他自身免疫/免疫相关疾病中进一步测试和探索。