Inflammation and type one diabetes
Inflammation and type one diabetes
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DOI：
10.1093/intimm/dxs049
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发表时间：
2012-06-01
影响因子：
4.4
通讯作者：
Cooke, Anne
中科院分区：
文献类型：
--
作者：
Bending, David;Zaccone, Paola;Cooke, Anne
1型糖尿病（T1 D）是一种复杂的T细胞介导的自身免疫性疾病，其定义特征是胰岛素分泌β细胞的破坏。遗传和环境因素联合收割机共同促成疾病，病理过程的结果取决于多种相互关联的因素。在这篇综述中，背后的机制的启动和传播的自身免疫反应进行了分析，并讨论了不同的T辅助细胞（T-h）亚群，特别是T（h）1和T（h）17相关的细胞因子的疾病过程的贡献。然后合成一个论点，提出β细胞对压力和炎症的反应是预测疾病结果的关键决定因素，并且在免疫学上，在胰岛浸润部位的调节和炎症之间存在微妙的平衡。因此，疾病干预的策略不仅需要通过向调节倾斜平衡来诱导T细胞耐受，而且还需要包含导致清除炎症介质的方法，以促进修复。最终，鉴于临床糖尿病在自身免疫过程中出现较晚，现在必须解决β细胞再生的策略。因此，需要在干细胞生物学家和免疫学家之间增加合作努力，以便为治疗这种使人衰弱的疾病定制最佳治疗策略。
Type one diabetes (T1D) is a complex T cell-mediated autoimmune disease, the defining feature of which is the destruction of the insulin-secreting beta- (beta)- cell. Both genetic and environmental factors combine to precipitate disease, and the outcome of the pathological process is dependent on multiple inter-related factors. In this review, the mechanisms behind the initiation and propagation of the autoimmune response are analysed, and the contribution of differing T-helper (T-h) subsets-in particular T(h)1- and T(h)17-related cytokines-to the disease process are discussed. An argument is then synthesized that proposes that the beta-cell's response to stress and inflammation is the critical determinant in predicting disease outcome and that, immunologically, a delicate balance exists between regulation and inflammation at the site of islet infiltration. Strategies for disease intervention, therefore, will not only require the induction of T-cell tolerance by tipping the balance towards regulation but will also need to contain approaches that result in the scavenging of inflammatory mediators, in order to facilitate repair. Ultimately, given that clinical diabetes presents late in the autoimmune process, strategies for beta-cell regeneration must now be addressed. There is thus a requirement for an increased, collaborative effort between stem cell biologists and immunologists in order to tailor an optimal therapeutic strategy for the treatment of this debilitating disease.