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糖尿病治疗中的免疫抑制剂:希望还是绝望?

Immunosuppressive agents in diabetes treatment: Hope or despair?

作者信息

Li Lu, Yang Xi, Ren Jin-Shuai, Huang Ming-Zhu, Zhao Qing-Wei

机构信息

Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.

出版信息

World J Diabetes. 2025 May 15;16(5):100590. doi: 10.4239/wjd.v16.i5.100590.

Abstract

Exploration of immunosuppressive agents for the treatment of diabetes is a burgeoning field that has captured the attention of the medical community. The innovative approach of using these agents to combat diabetes is driven by their diverse capabilities to regulate the immune system, which is pivotal for disease pathogenesis. The primary objective is to enhance the management of blood glucose levels, which is a critical factor in the daily life of diabetic patients. This comprehensive review delves into the therapeutic horizons opened by immunosuppressive agents, particularly their potential impact on type 1 and type 2 diabetes mellitus, and their utility in the transplantation process. The complex etiology of diabetes, which involves a delicate interplay of genetic, environmental, and immunological factors, presents a multifaceted target landscape for these therapies. The agents discussed in the review, including CD3 inhibitors, cytotoxic T-lymphocyte-associated protein 4-immunoglobulin G, Janus kinase inhibitors, anti-thymocyte globulin, tumor necrosis factor-α inhibitors, CD20 inhibitors, alefacept, and alemtuzumab, each bring a unique mechanism to the table, offering a tailored approach to immune modulation. As research progresses, emphasis is being placed on evaluating the long-term efficacy and safety of these agents to pave the way for more personalized and effective diabetes management strategies.

摘要

探索免疫抑制剂治疗糖尿病是一个新兴领域,已引起医学界的关注。使用这些药物对抗糖尿病的创新方法是由其调节免疫系统的多种能力驱动的,而免疫系统对疾病发病机制至关重要。主要目标是加强血糖水平的管理,这是糖尿病患者日常生活中的关键因素。这篇综述深入探讨了免疫抑制剂开辟的治疗前景,特别是它们对1型和2型糖尿病的潜在影响以及在移植过程中的效用。糖尿病复杂的病因涉及遗传、环境和免疫因素的微妙相互作用,为这些疗法提供了多方面的靶点。综述中讨论的药物,包括CD3抑制剂、细胞毒性T淋巴细胞相关蛋白4-免疫球蛋白G、Janus激酶抑制剂、抗胸腺细胞球蛋白、肿瘤坏死因子-α抑制剂、CD20抑制剂、阿法西普和阿仑单抗,每种药物都有独特的作用机制,为免疫调节提供了量身定制的方法。随着研究的进展,重点正在放在评估这些药物的长期疗效和安全性上,以便为更个性化和有效的糖尿病管理策略铺平道路。

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