The honeymoon phase: intersection of metabolism and immunology
The honeymoon phase: intersection of metabolism and immunology
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DOI：
10.1097/med.0b013e32832e0693
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发表时间：
2009-08-01
影响因子：
3.2
通讯作者：
Gottlieb, Peter
中科院分区：
文献类型：
--
作者：
Aly, Hanan;Gottlieb, Peter
综述目的尽管 1 型糖尿病的蜜月期已广为人知，但其潜在的致病机制仍知之甚少。根据最近的观察和研究，其发生是由于开始胰岛素治疗时“β细胞休息”而发生的常见解释似乎是不够的，并且忽视了其潜在的免疫学方面。最近的研究结果在本文中，我们将回顾蜜月期的代谢和免疫学方面，并将介绍我们目前该阶段的病理生理学模型。我们的观点是，这是许多缓解阶段之一，基本上是由于 1 型糖尿病病程中适应性免疫耐受的发展而发生的。我们还将回顾代谢因素（环境血糖水平）与免疫功能之间相互作用的新发现。总结蜜月期为了解 1 型糖尿病的发病机制提供了一个独特的模型。需要进行研究来阐明其免疫发病机制。事实证明，1 型糖尿病的最佳干预形式是将增强抗原特异性适应性免疫耐受与优化代谢控制相结合，以保持细胞毒性 T 细胞无反应性。
Purpose of reviewEven though the honeymoon phase in type 1 diabetes mellitus has been well known, its underlying pathogenic mechanisms remain poorly described. The common explanation that it occurs due to 'beta-cell rest' on initiation of insulin therapy seems inadequate based on recent observations and studies and its underlying immunological aspects overlooked.Recent findingsIn this article, we will review the metabolic and immunological aspects of the honeymoon phase and we will present our current model of the pathophysiology of this phase. Our view is that it is one of many phases of remission occurring basically due to development of adaptive immune tolerance along the course of type 1 diabetes. We will also review new findings of the interplay between metabolic factors (ambient glucose level) and immune function.SummaryThe honeymoon phase provides a unique model to understand the pathogenesis of type 1 diabetes. Research to unravel its immune pathogenesis is needed. It may turn out that the optimum form of intervention in type 1 diabetes is one that combines enhancement of antigen-specific adaptive immune tolerance with optimized metabolic control in order to keep cytotoxic T cells anergic.