Cheung Pierre, Eriksson Olof
Science for Life Laboratory, Department of Medicinal Chemistry, Uppsala University, SE-75183 Uppsala, Sweden.
Biomedicines. 2021 Dec 3;9(12):1824. doi: 10.3390/biomedicines9121824.
Diabetes is a chronic metabolic disease affecting over 400 million people worldwide and one of the leading causes of death, especially in developing nations. The disease is characterized by chronic hyperglycemia, caused by defects in the insulin secretion or action pathway. Current diagnostic methods measure metabolic byproducts of the disease such as glucose level, glycated hemoglobin (HbA1c), insulin or C-peptide levels, which are indicators of the beta-cell function. However, they inaccurately reflect the disease progression and provide poor longitudinal information. Beta-cell mass has been suggested as an alternative approach to study disease progression in correlation to beta-cell function, as it behaves differently in the diabetes physiopathology. Study of the beta-cell mass, however, requires highly invasive and potentially harmful procedures such as pancreatic biopsies, making diagnosis and monitoring of the disease tedious. Nuclear medical imaging techniques using radiation emitting tracers have been suggested as strong non-invasive tools for beta-cell mass. A highly sensitive and high-resolution technique, such as positron emission tomography, provides an ideal solution for the visualization of beta-cell mass, which is particularly essential for better characterization of a disease such as diabetes, and for estimating treatment effects towards regeneration of the beta-cell mass. Development of novel, validated biomarkers that are aimed at beta-cell mass imaging are thus highly necessary and would contribute to invaluable breakthroughs in the field of diabetes research and therapies. This review aims to describe the various biomarkers and radioactive probes currently available for positron emission tomography imaging of beta-cell mass, as well as highlight the need for precise quantification and visualization of the beta-cell mass for designing new therapy strategies and monitoring changes in the beta-cell mass during the progression of diabetes.
糖尿病是一种慢性代谢疾病，全球有超过4亿人受其影响，是主要死因之一，在发展中国家尤为如此。该疾病的特征是慢性高血糖，由胰岛素分泌或作用途径缺陷引起。目前的诊断方法测量该疾病的代谢副产物，如血糖水平、糖化血红蛋白（HbA1c）、胰岛素或C肽水平，这些都是β细胞功能的指标。然而，它们不能准确反映疾病进展，提供的纵向信息也很差。β细胞质量已被建议作为研究与β细胞功能相关的疾病进展的替代方法，因为它在糖尿病病理生理学中的表现不同。然而，研究β细胞质量需要高度侵入性且可能有害的程序，如胰腺活检，这使得疾病的诊断和监测变得繁琐。使用发射辐射示踪剂的核医学成像技术已被建议作为测量β细胞质量的强大非侵入性工具。一种高灵敏度和高分辨率的技术，如正电子发射断层扫描，为β细胞质量的可视化提供了理想的解决方案，这对于更好地表征糖尿病等疾病以及评估对β细胞质量再生的治疗效果尤为重要。因此，开发针对β细胞质量成像的新型、经过验证的生物标志物非常必要，这将为糖尿病研究和治疗领域带来宝贵的突破。本综述旨在描述目前可用于β细胞质量正电子发射断层扫描成像的各种生物标志物和放射性探针，并强调为设计新的治疗策略和监测糖尿病进展过程中β细胞质量的变化，精确量化和可视化β细胞质量的必要性。
