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1型糖尿病与自身免疫性疾病:对两者关联及个性化医疗应用的批判性综述

Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine.

作者信息

Popoviciu Mihaela Simona, Kaka Nirja, Sethi Yashendra, Patel Neil, Chopra Hitesh, Cavalu Simona

机构信息

Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania.

PearResearch, Dehradun 248001, India.

出版信息

J Pers Med. 2023 Feb 26;13(3):422. doi: 10.3390/jpm13030422.

Abstract

Type 1 Diabetes Mellitus (T1DM) is a common hyperglycemic disease characterized by the autoimmune destruction of insulin-producing beta cells of the pancreas. Various attempts have been made to understand the complex interplay of genetic and environmental factors which lead to the development of the autoimmune response in an individual. T1DM is frequently associated with other autoimmune illnesses, the most common being autoimmune thyroid disorders affecting more than 90% of people with T1D and autoimmune disorders. Antithyroid antibodies are present in around 20% of children with T1D at the start of the illness and are more frequent in girls. Patients with T1DM often have various other co-existing multi-system autoimmune disorders including but not limited to thyroid diseases, parathyroid diseases, celiac disease, vitiligo, gastritis, skin diseases, and rheumatic diseases. It is a consistent observation in clinics that T1DM patients have other autoimmune disorders which in turn affect their prognosis. Concomitant autoimmune illness might affect diabetes care and manifest itself clinically in a variety of ways. A thorough understanding of the complex pathogenesis of this modern-day epidemic and its association with other autoimmune disorders has been attempted in this review in order to delineate the measures to prevent the development of these conditions and limit the morbidity of the afflicted individuals as well. The measures including antibody screening in susceptible individuals, early identification and management of other autoimmune disorders, and adoption of personalized medicine can significantly enhance the quality of life of these patients. Personalized medicine has recently gained favor in the scientific, medical, and public domains, and is frequently heralded as the future paradigm of healthcare delivery. With the evolution of the 'omics', the individualization of therapy is not only closer to reality but also the need of the hour.

摘要

1型糖尿病(T1DM)是一种常见的高血糖疾病,其特征是胰腺中产生胰岛素的β细胞发生自身免疫性破坏。人们已经进行了各种尝试,以了解导致个体自身免疫反应发生的遗传和环境因素之间的复杂相互作用。T1DM常与其他自身免疫性疾病相关,最常见的是自身免疫性甲状腺疾病,影响超过90%的T1D患者和自身免疫性疾病患者。在疾病开始时,约20%的T1D儿童体内存在抗甲状腺抗体,且在女孩中更为常见。T1DM患者通常还存在各种其他并存的多系统自身免疫性疾病,包括但不限于甲状腺疾病、甲状旁腺疾病、乳糜泻、白癜风、胃炎、皮肤病和风湿性疾病。临床上一致观察到,T1DM患者存在其他自身免疫性疾病,这反过来又会影响他们的预后。伴随的自身免疫性疾病可能会影响糖尿病的治疗,并以多种方式在临床上表现出来。本综述试图全面了解这种现代流行病的复杂发病机制及其与其他自身免疫性疾病的关联,以便描绘出预防这些疾病发生和限制患病个体发病率的措施。这些措施包括对易感个体进行抗体筛查、早期识别和管理其他自身免疫性疾病,以及采用个性化医疗,可显著提高这些患者的生活质量。个性化医疗最近在科学、医学和公共领域受到青睐,并经常被誉为未来医疗服务的范式。随着“组学”的发展,治疗的个体化不仅更接近现实,而且是当务之急。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7523/10056161/47aae1a4fabc/jpm-13-00422-g001.jpg

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