Re-Enlightenment of Fulminant Type 1 Diabetes under the COVID-19 Pandemic.
Re-Enlightenment of Fulminant Type 1 Diabetes under the COVID-19 Pandemic.
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DOI：
10.3390/biology11111662
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发表时间：
2022-11-15
期刊：
影响因子：
4.2
通讯作者：
Imagawa, Akihisa
中科院分区：
文献类型：
--
作者：
Sano, Hiroyuki;Imagawa, Akihisa
关键词：
从2019年开始，由新型严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）在全球范围内蔓延，成为一个严重的问题。众所周知，各种病毒参与了1型糖尿病（T1 D）的发展，但关于SARS-CoV-2和T1 D之间关联的报道是混合的。暴发性1型糖尿病（FT 1D）是T1 D的一种亚型，主要在东亚报道。自身免疫性1型糖尿病（AT 1D）的特征在于慢性胰腺β细胞破坏，而FT 1D的特征在于流感样症状后快速且几乎完全的胰岛破坏，导致酮症酸中毒，在某些情况下，猝死。在讨论COVID-19和T1 D之间的关联时，也有必要关注FT 1D。然而，在不理解概念的情况下诊断这种亚型并不容易。因此，作者在此回顾了这一概念和最新发现，希望未来能够充分评估COVID-19和T1 D之间的关联。暴发性1型糖尿病（FT 1D）是1型糖尿病（T1 D）的一种亚型，其特征是在快速且几乎完全破坏胰岛的背景下快速进展为糖尿病酮症酸中毒。FT 1D发作时的HbA 1c水平保持正常或轻微升高，尽管有明显的高血糖，反映了疾病的快速临床病程，是诊断的重要标志物。FT 1D通常出现在流感样症状之后，并且有许多报告称其发病与病毒感染有关。此外，疾病易感基因已被确定在FT 1D，表明宿主因素参与疾病的发展。在大多数情况下，未检测到胰岛相关的自身抗体，胰腺组织的组织学显示在FT 1D的早期阶段胰岛的巨噬细胞和T细胞浸润，这表明胰岛破坏通过与自身免疫性1型糖尿病不同的免疫反应发生。从2019年开始，由新型严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）在全球范围内蔓延，成为一个严重的问题。关于SARS-CoV-2和T1 D之间关联的报告喜忧参半，有些报告认为，由于COVID-19大流行，T1 D发病率有所增加。在讨论COVID-19和T1 D之间的关联时，也有必要关注FT 1D。然而，在不理解概念的情况下诊断这种亚型并不容易。因此，作者在此回顾了FT 1D的概念和最新发现，希望未来能够充分评估COVID-19与T1 D之间的关联。
From 2019, coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread worldwide and became a serious problem. It is known that various viruses are involved in the development of type 1 diabetes (T1D), but the reports of an association between SARS-CoV-2 and T1D are mixed. Fulminant type 1 diabetes (FT1D) is a subtype of T1D mainly reported from East Asia. Autoimmune type 1 diabetes (AT1D) is characterized by chronic pancreatic β-cell destruction, whereas FT1D is characterized by rapid and almost complete islet destruction following flu-like symptoms, leading to ketoacidosis and, in some cases, sudden death. When discussing the association between COVID-19 and T1D, it is also necessary to focus on FT1D. However, it is not easy to diagnose this subtype without understanding the concept. Therefore, the authors hereby review the concept and latest findings, hoping that the association between COVID-19 and T1D will be adequately evaluated in the future. Fulminant type 1 diabetes (FT1D) is a subtype of type 1 diabetes (T1D) that is characterized by the rapid progression to diabetic ketoacidosis against the background of rapid and almost complete pancreatic islet destruction. The HbA1c level at FT1D onset remains normal or slightly elevated despite marked hyperglycemia, reflecting the rapid clinical course of the disease, and is an important marker for diagnosis. FT1D often appears following flu-like symptoms, and there are many reports of its onset being linked to viral infections. In addition, disease-susceptibility genes have been identified in FT1D, suggesting the involvement of host factors in disease development. In most cases, islet-related autoantibodies are not detected, and histology of pancreatic tissue reveals macrophage and T cell infiltration of the islets in the early stages of FT1D, suggesting that islet destruction occurs via an immune response different from that occurring in autoimmune type 1 diabetes. From 2019, coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread worldwide and became a serious problem. Reports on the association between SARS-CoV-2 and T1D are mixed, with some suggesting an increase in T1D incidence due to the COVID-19 pandemic. When discussing the association between COVID-19 and T1D, it is also necessary to focus on FT1D. However, it is not easy to diagnose this subtype without understanding the concept. Therefore, authors hereby review the concept and the latest findings of FT1D, hoping that the association between COVID-19 and T1D will be adequately evaluated in the future.
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