Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
Department of Physiology & Pathophysiology, University of Manitoba, Winnipeg, MB, Canada.
Diabetologia. 2023 Nov;66(11):1971-1982. doi: 10.1007/s00125-023-05970-z. Epub 2023 Jul 25.
Type 1 diabetes results from the poorly understood process of islet autoimmunity, which ultimately leads to the loss of functional pancreatic beta cells. Mounting evidence supports the notion that the activation and evolution of islet autoimmunity in genetically susceptible people is contingent upon early life exposures affecting the islets, especially beta cells. Here, we review some of the recent advances and studies that highlight the roles of these changes as well as antigen presentation and stress response pathways in beta cells in the onset and propagation of the autoimmune process in type 1 diabetes. Future progress in this area holds promise for advancing islet- and beta cell-directed therapies that could be implemented in the early stages of the disease and could be combined with immunotherapies.
1 型糖尿病是由胰岛自身免疫这一过程引起的，但其机制尚未完全阐明，而胰岛自身免疫最终会导致功能性胰腺β细胞的丧失。越来越多的证据支持这样一种观点，即遗传易感人群中胰岛自身免疫的激活和演变取决于生命早期暴露于影响胰岛，尤其是β细胞的因素。在这里，我们回顾了一些最近的进展和研究，这些研究强调了这些变化以及抗原呈递和应激反应途径在 1 型糖尿病自身免疫过程的发生和发展中的作用。该领域的未来进展有望推动胰岛和β细胞靶向治疗的发展，这些治疗可以在疾病的早期阶段实施，并可以与免疫疗法相结合。
