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自身免疫性1型糖尿病:AGORA糖尿病协作组对西班牙的早期方法评估

Autoimmune Type 1 Diabetes: An Early Approach Appraisal for Spain by the AGORA Diabetes Collaborative Group.

作者信息

Gómez-Peralta Fernando, Pinés-Corrales Pedro J, Santos Estefanía, Cuesta Martín, González-Albarrán Olga, Azriel Sharona, Castaño Luis, Mathieu Chantal

机构信息

Endocrinology and Nutrition Unit, Hospital General de Segovia, 40002 Segovia, Spain.

Endocrinology and Nutrition Service, Complejo Hospitalario Universitario de Albacete, 02008 Albacete, Spain.

出版信息

J Clin Med. 2025 Jan 10;14(2):418. doi: 10.3390/jcm14020418.

Abstract

Type 1 diabetes (T1D) is an autoimmune disorder characterized by the destruction of insulin-producing pancreatic beta-cells, leading to lifelong insulin dependence. This review explores the current understanding of T1D pathogenesis, clinical progression, and emerging therapeutic approaches. We examined the complex interplay between genetic predisposition and environmental factors that could trigger the autoimmune response as well as the immunological mechanisms involved in beta-cell destruction. The clinical phases of T1D are discussed from the preclinical stage through diagnosis and long-term management, highlighting the importance of early detection and intervention. Recent advancements in treatment strategies are presented, including immunomodulatory therapies and potential cell-based treatments aimed at preserving or restoring beta-cell function. Additionally, this review critically evaluates the feasibility and potential benefits of implementing a population-wide screening program for T1D in Spain. The epidemiological, economic, and ethical implications of such an initiative were considered by the national expert panel, focusing on the potential of early diagnosis to improve clinical outcomes in the face of the challenges of large-scale implementation. This comprehensive analysis aims to provide healthcare professionals, researchers, and policymakers with valuable insights into the current landscape of T1D management and prospects for enhanced prevention and treatment strategies in the Spanish context.

摘要

1型糖尿病(T1D)是一种自身免疫性疾病,其特征是产生胰岛素的胰腺β细胞被破坏,导致终身依赖胰岛素。本综述探讨了目前对T1D发病机制、临床进展和新兴治疗方法的理解。我们研究了遗传易感性和环境因素之间复杂的相互作用,这些因素可能引发自身免疫反应以及β细胞破坏所涉及的免疫机制。从临床前期阶段到诊断及长期管理,讨论了T1D的临床阶段,强调了早期检测和干预的重要性。介绍了治疗策略的最新进展,包括免疫调节疗法和旨在保留或恢复β细胞功能的潜在细胞疗法。此外,本综述批判性地评估了在西班牙实施针对T1D的全人群筛查计划的可行性和潜在益处。国家专家小组考虑了这一举措的流行病学、经济和伦理影响,重点关注在大规模实施面临挑战的情况下早期诊断改善临床结局的潜力。这一全面分析旨在为医疗保健专业人员、研究人员和政策制定者提供有关T1D管理现状以及在西班牙背景下加强预防和治疗策略前景的宝贵见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22fa/11766439/0cac96b9ff6a/jcm-14-00418-g001.jpg

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