Ray Sayantan, Palui Rajan
Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar 751019, India.
Department of Endocrinology, The Mission Hospital, Durgapur 713212, India.
World J Diabetes. 2024 Oct 15;15(10):2022-2035. doi: 10.4239/wjd.v15.i10.2022.
Since the discovery of insulin over 100 years ago, the focus of research in the management of type 1 diabetes (T1D) has centered around glycemic control and management of complications rather than the prevention of autoimmune destruction of pancreatic β cells. Fortunately, in recent years, there has been significant advancement in immune-targeted pharmacotherapy to halt the natural progression of T1D. The immune-targeted intervention aims to alter the underlying pathogenesis of T1D by targeting different aspects of the immune system. The immunotherapy can either antagonize the immune mediators like T cells, B cells or cytokines (antibody-based therapy), or reinduce self-tolerance to pancreatic β cells (antigen-based therapy) or stem-cell treatment. Recently, the US Food and Drug Administration approved the first immunotherapy teplizumab to be used only in stage 2 of T1D. However, the window of opportunity to practically implement this approved molecule in the selected target population is limited. In this Editorial, we briefly discuss the various promising recent developments in the field of immunotherapy research in T1D. However, further studies of these newer therapeutic agents are needed to explore their true potential for prevention or cure of T1D.
自100多年前发现胰岛素以来，1型糖尿病（T1D）管理的研究重点一直围绕血糖控制和并发症管理，而非预防胰腺β细胞的自身免疫性破坏。幸运的是，近年来，在旨在阻止T1D自然进展的免疫靶向药物治疗方面取得了重大进展。免疫靶向干预旨在通过针对免疫系统的不同方面来改变T1D的潜在发病机制。免疫疗法既可以拮抗免疫介质，如T细胞、B细胞或细胞因子（基于抗体的疗法），也可以重新诱导对胰腺β细胞的自身耐受性（基于抗原的疗法）或干细胞治疗。最近，美国食品药品监督管理局批准了首个免疫疗法药物替普珠单抗，仅用于T1D的2期。然而，在选定的目标人群中实际应用这种获批分子的机会窗口有限。在这篇社论中，我们简要讨论了T1D免疫疗法研究领域最近各种有前景进展。然而，需要对这些更新的治疗药物进行进一步研究，以探索它们预防或治愈T1D的真正潜力。
