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The role of beta-cell dysfunction in early type 1 diabetes.
Current Opinion in Endocrinology, Diabetes and Obesity ( IF 3.2 ) Pub Date : 2020-08-01 , DOI: 10.1097/med.0000000000000548
Emily K Sims 1, 2, 3, 4 , Raghavendra G Mirmira 5 , Carmella Evans-Molina 1, 2, 3, 4, 6, 7, 8
Affiliation  

Purpose of review 

Emerging data have suggested that β-cell dysfunction may exacerbate the development and progression of type 1 diabetes (T1D). In this review, we highlight clinical and preclinical studies suggesting a role for β-cell dysfunction during the evolution of T1D and suggest agents that may promote β-cell health in T1D.

Recent findings 

Metabolic abnormalities exist years before development of hyperglycemia and exhibit a reproducible pattern reflecting progressive deterioration of β-cell function and increases in β-cell stress and death. Preclinical studies indicate that T1D may be prevented by modification of pathways impacting intrinsic β-cell stress and antigen presentation. Recent findings suggest that differences in metabolic phenotypes and β-cell stress may reflect differing endotypes of T1D. Multiple pathways representing potential drug targets have been identified, but most remain to be tested in human populations with preclinical disease.

Summary 

This cumulative body of work shows clear evidence that β-cell stress, dysfunction, and death are harbingers of impending T1D and likely contribute to progression of disease and insulin deficiency. Treatment with agents targeting β-cell health could augment interventions with immunomodulatory therapies but will need to be tested in intervention studies with endpoints carefully designed to capture changes in β-cell function and health.



中文翻译:

β 细胞功能障碍在早期 1 型糖尿病中的作用。

审查目的 

新出现的数据表明,β 细胞功能障碍可能会加剧1 型糖尿病(T1D)的发生和进展。在这篇综述中,我们强调了临床和临床前研究表明β 细胞功能障碍在 T1D 演变过程中的作用,并提出了可促进T1D 中β 细胞健康的药物。

最近的发现 

代谢异常在高血糖发生前数年就存在,并表现出一种可重复的模式,反映了 β 细胞功能的进行性恶化以及 β 细胞应激和死亡的增加。临床前研究表明,可以通过改变影响内在 β 细胞应激和抗原呈递的途径来预防 T1D。最近的研究结果表明,代谢表型和 β 细胞应激的差异可能反映了 T1D 的不同内型。已经确定了代表潜在药物靶标的多种途径,但大多数仍有待在患有临床前疾病的人群中进行测试。

概括 

这些累积的工作表明,β 细胞应激、功能障碍和死亡是即将发生的 T1D 的先兆,并可能导致疾病进展和胰岛素缺乏。使用针对β 细胞健康的药物进行治疗可以增强免疫调节疗法的干预,但需要在干预研究中进行测试,并精心设计终点以捕捉 β 细胞功能和健康的变化。

更新日期:2020-07-02
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