Immunotherapeutic Treatment of Autoimmune Diabetes
Immunotherapeutic Treatment of Autoimmune Diabetes
复制标题
DOI：
10.1615/critrevimmunol.2013006913
复制
发表时间：
2013-01-01
影响因子：
1.3
通讯作者：
Lee, Myung-Shik
中科院分区：
文献类型：
--
作者：
Kim, Jae Hyeon;Jin, Sang-Man;Lee, Myung-Shik
1型糖尿病是一种典型的器官特异性自身免疫性疾病。已经尝试了使用胰岛素或谷氨酸脱羧酶肽和其他免疫疗法（例如抗体、融合蛋白、细胞因子、调节性T细胞、小分子抑制剂、非特异性免疫调节剂或饮食改变）的多种抗原特异性免疫疗法用于人类1型糖尿病。这些免疫疗法中的一些延迟糖尿病的发作或降低已确诊的1型糖尿病患者的胰岛素需求或血糖水平。然而，这些免疫疗法中的大多数未能诱导已确诊的1型糖尿病的完全缓解，这可能是由于1）实现对糖尿病自身抗原的免疫耐受或抑制对可应用于这些抗原的自身免疫反应的技术困难人类患者没有显着的不良反应，和2）在疾病发作时β-细胞量显著减少，应当补充。本综述着重于疾病的免疫学方面及其治疗，并从以前或正在进行的人体临床试验中使用免疫学措施的数据，以及最近的结果，采用动物模型的免疫学研究进行了讨论。
Type 1 diabetes is a prototypic, organ-specific autoimmune disease. Diverse antigen-specific immunotherapy using insulin or glutamic acid decarboxylase peptides and other immunotherapies, such as antibodies, fusion proteins, cytokines, regulatory T cells, small-molecule inhibitors, nonspecific immune modulators, or dietary modifications, have been attempted in human type 1 diabetes. Some of these immunotherapies delay the onset of diabetes or reduce insulin requirements or blood glucose level in patients with established type 1 diabetes. However, most of these immunotherapies failed to induce complete remission of established type 1 diabetes, which could be due to 1) technical difficulties in the achievement of immune tolerance to diabetic autoantigens or in the inhibition of autoimmune responses to those antigens that can be applied to human patients without significant adverse effects, and 2) markedly reduced beta-cell mass at the time of disease onset that should be replenished. This review focuses on the immunological aspects of the disease and its treatment, and data from previous or ongoing human clinical trials using immune-logical measures, and recent results from immunological studies employing animal models are discussed.