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The Pathogenesis of Type 1 Diabetes 1 型糖尿病的发病机制
IF 5.4 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-12 DOI: 10.1101/cshperspect.a041623
Kevan C. Herold, Jeffrey P. Krischer
Type 1 diabetes (T1D) is a chronic autoimmune disease with a metabolic outcome. Studies over the past decades, have identified the contributions of genetics, environmental factors, and disorders of innate and adaptive immunity that collectively cause β-cell killing. The risk for T1D can be genetically identified but genotypes alone do not identify factors that lead to disease progression. The incidence of T1D has been increasing in the past few decades, which may be due to reduced exposure to infections and other environmental factors that can reduce autoimmunity (hygiene hypothesis). Once initiated, the disease pathogenesis progresses through stages that have been defined on the bases of immunologic (i.e., autoantibodies) and metabolic markers (glucose tolerance). The stages only loosely capture the risk for the time to diagnosis of disease, do not directly reflect disease activity, and there may be variance in the rate of progression within stages. In a general way, the stages can be used to identify patients at risk in whom interventions may be considered to modulate progression. This was achieved with the approval of teplizumab, a humanized anti-CD3 monoclonal antibody, for delaying the diagnosis of T1D.
1 型糖尿病(T1D)是一种慢性自身免疫性疾病,会导致新陈代谢紊乱。过去几十年的研究发现,遗传、环境因素以及先天性和适应性免疫紊乱共同导致了β细胞杀伤。T1D的风险可以从基因上确定,但仅凭基因型并不能确定导致疾病进展的因素。在过去几十年中,T1D 的发病率一直在上升,这可能是由于接触感染和其他环境因素的机会减少,从而降低了自身免疫力(卫生假说)。一旦发病,疾病的发病机制就会经历几个阶段,这些阶段是根据免疫学指标(即自身抗体)和代谢指标(葡萄糖耐量)确定的。这些阶段只是粗略地反映了疾病诊断时间的风险,并不能直接反映疾病的活动性,而且阶段内的进展速度可能存在差异。一般来说,分期可用于确定有风险的患者,对这些患者可考虑采取干预措施以控制病情发展。随着人源化抗 CD3 单克隆抗体 teplizumab 获得批准用于延迟 T1D 的诊断,这一目标已经实现。
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引用次数: 0
The Human Pancreas in Type 1 Diabetes: Lessons Learned from the Network of Pancreatic Organ Donors with Diabetes 1 型糖尿病患者的人体胰腺:从糖尿病胰腺器官捐赠者网络中汲取的经验教训
IF 5.4 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-12 DOI: 10.1101/cshperspect.a041588
Irina Kusmartseva, Amanda Posgai, Mingder Yang, Richard Oram, Mark Atkinson, Alberto Pugliese, Carmella Evans-Molina
The Network for Pancreatic Organ Donors with Diabetes (nPOD) has helped shape the contemporary understanding of type 1 diabetes (T1D) pathogenesis in humans through the procurement, distribution to scientists, and collaborative study of human pancreata and disease-related tissues from organ donors with T1D and islet autoantibody positivity. Since its inception in 2007, nPOD has collected tissues from 600 donors, and these resources have been distributed across 22 countries to more than 290 projects, resulting in nearly 350 publications. Research projects supported by nPOD span the breadth of diabetes research, including studies on T1D immunology and β-cell biology, and have uniquely unveiled abnormalities in other pancreatic cell types. In this article, we will detail the history and programmatic features of nPOD, as well as highlight key scientific findings from nPOD studies. We will present our view for the future of nPOD and discuss how the success of the program has established a precedent whereby knowledge gaps in biomedical research can be addressed through the study of human tissues.
糖尿病胰腺器官捐献者网络(nPOD)通过从患有 T1D 和胰岛自身抗体阳性的器官捐献者那里获取人体胰腺和疾病相关组织,并将其分发给科学家和进行合作研究,帮助当代人了解 1 型糖尿病(T1D)的发病机制。自 2007 年成立以来,nPOD 已从 600 名捐献者那里收集了组织,这些资源已在 22 个国家分配给 290 多个项目,发表了近 350 篇论文。由 nPOD 支持的研究项目涉及糖尿病研究的方方面面,包括 T1D 免疫学和 β 细胞生物学研究,并独特地揭示了其他胰腺细胞类型的异常。在本文中,我们将详细介绍 nPOD 的历史和计划特点,并重点介绍 nPOD 研究的主要科学发现。我们将介绍我们对 nPOD 未来的看法,并讨论该计划的成功如何开创了一个先例,即通过研究人体组织来解决生物医学研究中的知识空白。
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引用次数: 0
Genetics and Epigenetics of Type 1 Diabetes Self-Reactive T Cells 1 型糖尿病自反应 T 细胞的遗传学和表观遗传学
IF 5.4 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-12 DOI: 10.1101/cshperspect.a041586
Tae Gun Kang, Benjamin Youngblood
Type 1 diabetes (T1D) serves as an exemplar of chronic autoimmune disease characterized by insulin deficiency due to pancreatic β-cell destruction, leading to hyperglycemia and progressive organ failure. Until recently, therapeutic efforts to mitigate the root cause of disease have been limited by the challenges in studying mechanisms involved in immune tolerance in humans. The current clinical advances, and existing challenges, highlight a need to incorporate new insights into mechanisms into correlative studies that assess immune tolerance in the setting of delayed β-cell destruction. Among several factors known to promote T1D, autoreactive T cells play a critical role in initiating and sustaining disease through their direct recognition and destruction of β cells. Emerging research defining the genetic and epigenetic etiology of long-lived β-cell-specific T cells is providing new insight into mechanisms that promote lifelong disease and future opportunities for targeted therapeutic intervention. This article will provide an overview of recent progress toward understanding the development of autoreactive T cells and epigenetic mechanisms stabilizing their developmental state during T1D pathogenesis.
1 型糖尿病(T1D)是慢性自身免疫性疾病的典范,其特点是胰岛β细胞破坏导致胰岛素缺乏,从而引发高血糖和渐进性器官衰竭。直到最近,由于在研究人体免疫耐受机制方面存在挑战,缓解疾病根源的治疗工作一直受到限制。目前的临床进展和现有的挑战突出表明,有必要将对机制的新认识纳入相关研究,以评估延迟β细胞破坏情况下的免疫耐受性。在已知的几种促进 T1D 的因素中,自反应 T 细胞通过直接识别和破坏 β 细胞,在引发和维持疾病方面起着至关重要的作用。界定长寿命 β 细胞特异性 T 细胞的遗传和表观遗传学病因学的新兴研究为了解促进终生疾病的机制和未来靶向治疗干预的机会提供了新的视角。本文将概述最近在了解自反应性 T 细胞的发育以及在 T1D 发病过程中稳定其发育状态的表观遗传学机制方面取得的进展。
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引用次数: 0
Genetics of Parkinson's Disease: From Causes to Treatment 帕金森病的遗传学:从病因到治疗
IF 5.4 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-12 DOI: 10.1101/cshperspect.a041774
Ana Westenberger, Norbert Brüggemann, Christine Klein
The genetic architecture of Parkinson's disease (PD) comprises five autosomal dominantly inherited forms with a clinical picture overall resembling idiopathic disease (PARK-SNCA, PARK-LRRK2, PARK-VPS35, PARK-CHCHD2, and PARK-RAB32) and three recessive types (PARK-PRKN, PARK-PINK1, and PARK-PARK7), several monogenic forms causing atypical parkinsonism, as well as a plethora of known genetic risk factors, most notably SNCA and GBA1 including a recently discovered risk variant unique to individuals of African descent, as well as polygenic scores. The Movement Disorder Society Genetic mutation database (MDSGene) (www.mdsgene.org) provides PD genotype–phenotype relationships, whereas global PD genetics networks, such as the Global Parkinson's Genetics Program (www.gp2.org) elucidate PD genetic factors at an unprecedented scale. Two large studies in relatively unselected, multicenter PD samples estimate the frequency of genetic forms, including PARK-GBA1, at ∼15%. PD genetics are becoming increasingly actionable, with the first gene-targeted clinical trials underway. Furthermore, PD genetics has recently been incorporated into a new biological classification of PD.
帕金森病(PD)的遗传结构包括五种常染色体显性遗传类型(PARK-SNCA、PARK-LRRK2、PARK-VPS35、PARK-CHCHD2 和 PARK-RAB32)和三种隐性遗传类型(PARK-PRKN、PARK-PINK1和PARK-PARK7)、几种导致非典型帕金森病的单基因型,以及大量已知的遗传风险因素,其中最主要的是SNCA和GBA1,包括最近发现的一种非洲后裔特有的风险变异,以及多基因评分。运动障碍协会基因突变数据库(MDSGene)(www.mdsgene.org)提供了帕金森病基因型与表型的关系,而全球帕金森病遗传学网络,如全球帕金森病遗传学计划(www.gp2.org),则以前所未有的规模阐明了帕金森病的遗传因素。在相对未经选择的多中心帕金森病样本中进行的两项大型研究估计,包括 PARK-GBA1 在内的遗传形式的频率为 15%。帕金森病遗传学越来越具有可操作性,首批基因靶向临床试验正在进行中。此外,帕金森病遗传学最近已被纳入新的帕金森病生物学分类中。
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引用次数: 0
The Role of B Lymphocytes in Type 1 Diabetes B 淋巴细胞在 1 型糖尿病中的作用
IF 5.4 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-12 DOI: 10.1101/cshperspect.a041593
Mia J. Smith, Joanne Boldison, F. Susan Wong
While autoreactive T cells are known to induce β-cell death in type 1 diabetes (T1D), self-reactive B cells also play an important role in the pathogenesis of T1D. Studies have shown that individuals living with T1D have an increased frequency of self-reactive B cells that escape from the bone marrow and populate peripheral organs, become activated, and participate in disease. These failed tolerance mechanisms may be attributed to genetic risk alleles that are associated with the development of T1D. Once in the periphery, these self-reactive B cells act as important antigen-presenting cells to autoreactive T cells and produce autoantibodies that are used to predict individuals at risk for or diagnosed with T1D. Here, we discuss the evidence that B cells are important in the pathogenesis of T1D, how these cells escape normal tolerance mechanisms, their role in disease progression, and how targeting these cells and/or monitoring them as biomarkers for response to therapy will be of clinical benefit.
众所周知,自身反应性 T 细胞会诱导 1 型糖尿病(T1D)β 细胞死亡,而自身反应性 B 细胞在 T1D 的发病机制中也扮演着重要角色。研究表明,T1D 患者体内自我反应性 B 细胞的出现频率增加,这些 B 细胞从骨髓中逃逸出来,在外周器官中增殖、活化并参与疾病的发生。这些失效的耐受机制可能与 T1D 发病相关的遗传风险等位基因有关。一旦进入外周,这些自我反应性 B 细胞就会成为自反应性 T 细胞的重要抗原递呈细胞,并产生自身抗体,用于预测有 T1D 风险或被诊断为 T1D 的个体。在这里,我们将讨论 B 细胞在 T1D 发病机制中起重要作用的证据、这些细胞如何逃避正常的耐受机制、它们在疾病进展中的作用,以及靶向这些细胞和/或监测它们作为治疗反应的生物标志物将如何对临床有益。
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引用次数: 0
Mouse Models of Metastasis and Dormancy. 小鼠转移和休眠模型。
IF 7.8 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-01 DOI: 10.1101/cshperspect.a041386
Ahmed Mahmoud, Karuna Ganesh

Metastasis is the ultimate and often lethal stage of cancer. Metastasis occurs in three phases that may vary across individuals: First, dissemination from the primary tumor. Second, tumor dormancy at the metastatic site where micrometastatic cancer cells remain quiescent or, in dynamic cycles of proliferation and elimination, remaining clinically undetectable. Finally, cancer cells are able to overcome microenvironmental constraints for outgrowth, or the formation of clinically detectable macrometastases that colonize distant organs and are largely incurable. A variety of approaches have been used to model metastasis to elucidate molecular mechanisms and identify putative therapeutic targets. In particular, metastatic dormancy has been challenging to model in vivo due to the sparse numbers of cancer cells in micrometastasis nodules and the long latency times required for tumor outgrowth. Here, we review state-of-the art genetically engineered mouse, syngeneic, and patient-derived xenograft approaches for modeling metastasis and dormancy. We describe the advantages and limitations of various metastasis models, novel findings enabled by such approaches, and highlight opportunities for future improvement.

转移是癌症的最终阶段,往往是致命的阶段。转移发生在三个阶段,可能因人而异:第一,从原发肿瘤扩散。其次,转移部位的肿瘤休眠,微转移癌细胞保持静止状态,或者在增殖和消除的动态循环中,在临床上无法检测到。最后,癌细胞能够克服生长的微环境限制,或者形成临床可检测的大转移瘤,这些转移瘤定植在远处器官上,并且在很大程度上是不可治愈的。多种方法已被用于模拟转移,以阐明分子机制和确定假定的治疗靶点。特别是,由于微转移结节中癌细胞数量稀少以及肿瘤生长所需的长潜伏期,转移性休眠在体内建模一直具有挑战性。在这里,我们回顾了最先进的基因工程小鼠、同基因和患者来源的异种移植方法来模拟转移和休眠。我们描述了各种转移模型的优点和局限性,这些方法带来的新发现,并强调了未来改进的机会。
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引用次数: 0
Germline Genetic Testing for Hereditary Breast and Ovarian Cancer: Current Concepts in Risk Evaluation. 遗传性乳腺癌和卵巢癌的基因检测:风险评估的当前概念》。
IF 7.8 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-01 DOI: 10.1101/cshperspect.a041318
Siddhartha Yadav, Fergus J Couch, Susan M Domchek

Our understanding of hereditary breast and ovarian cancer has significantly improved over the past two decades. In addition to BRCA1/2, pathogenic variants in several other DNA-repair genes have been shown to increase the risks of breast and ovarian cancer. The magnitude of cancer risk is impacted not only by the gene involved, but also by family history of cancer, polygenic risk scores, and, in certain genes, pathogenic variant type or location. While estimates of breast and ovarian cancer risk associated with pathogenic variants are available, these are predominantly based on studies of high-risk populations with young age at diagnosis of cancer, multiple primary cancers, or family history of cancer. More recently, breast cancer risk for germline pathogenic variant carriers has been estimated from population-based studies. Here, we provide a review of the field of germline genetic testing and risk evaluation for hereditary breast and ovarian cancers in high-risk and population-based settings.

在过去二十年中,我们对遗传性乳腺癌和卵巢癌的认识有了显著提高。除 BRCA1/2 外,其他几个 DNA 修复基因的致病变异也被证明会增加罹患乳腺癌和卵巢癌的风险。癌症风险的大小不仅受相关基因的影响,还受癌症家族史、多基因风险评分以及某些基因的致病变异类型或位置的影响。虽然目前已有与致病变异相关的乳腺癌和卵巢癌风险估计值,但这些估计值主要是基于对确诊癌症时年龄较小、患有多种原发性癌症或有癌症家族史的高危人群的研究。最近,基于人群的研究估算了种系致病变异携带者患乳腺癌的风险。在此,我们将对高风险和基于人群的遗传性乳腺癌和卵巢癌的种系基因检测和风险评估领域进行综述。
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引用次数: 0
Resistance and Resilience to Alzheimer's Disease. 对阿尔茨海默病的抵抗力和复原力。
IF 7.8 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-01 DOI: 10.1101/cshperspect.a041201
Caitlin S Latimer, Katherine E Prater, Nadia Postupna, C Dirk Keene

Dementia is a significant public health crisis; the most common underlying cause of age-related cognitive decline and dementia is Alzheimer's disease neuropathologic change (ADNC). As such, there is an urgent need to identify novel therapeutic targets for the treatment and prevention of the underlying pathologic processes that contribute to the development of AD dementia. Although age is the top risk factor for dementia in general and AD specifically, these are not inevitable consequences of advanced age. Some individuals are able to live to advanced age without accumulating significant pathology (resistance to ADNC), whereas others are able to maintain cognitive function despite the presence of significant pathology (resilience to ADNC). Understanding mechanisms of resistance and resilience will inform therapeutic strategies to promote these processes to prevent or delay AD dementia. This article will highlight what is currently known about resistance and resilience to AD, including our current understanding of possible underlying mechanisms that may lead to candidate preventive and treatment interventions for this devastating neurodegenerative disease.

痴呆症是一个重大的公共卫生危机;与年龄相关的认知能力下降和痴呆症最常见的根本原因是阿尔茨海默病的神经病理变化(ADNC)。因此,迫切需要确定新的治疗靶点,以治疗和预防导致阿尔茨海默病痴呆症发展的潜在病理过程。虽然年龄是导致痴呆症(尤其是老年痴呆症)的首要风险因素,但这并不是高龄的必然结果。有些人能够活到晚年而不积累明显的病理变化(对 ADNC 的抵抗力),而另一些人则能够在存在明显病理变化的情况下保持认知功能(对 ADNC 的恢复力)。了解抵抗力和恢复力的机制将为治疗策略提供依据,从而促进这些过程,预防或延缓AD痴呆症的发生。本文将重点介绍目前已知的有关AD抵抗力和恢复力的知识,包括我们目前对可能的潜在机制的理解,这些机制可能导致针对这种破坏性神经退行性疾病的候选预防和治疗干预措施。
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引用次数: 0
Optogenetic Vision Restoration. 光遗传学视力恢复。
IF 7.8 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-01 DOI: 10.1101/cshperspect.a041660
Volker Busskamp, Botond Roska, Jose-Alain Sahel

Optogenetics has emerged over the past 20 years as a powerful tool to investigate the various circuits underlying numerous functions, especially in neuroscience. The ability to control by light the activity of neurons has enabled the development of therapeutic strategies aimed at restoring some level of vision in blinding retinal conditions. Promising preclinical and initial clinical data support such expectations. Numerous challenges remain to be tackled (e.g., confirmation of safety, cell and circuit specificity, patterns, intensity and mode of stimulation, rehabilitation programs) on the path toward useful vision restoration.

在过去的20年里,光遗传学已经成为研究许多功能背后的各种电路的有力工具,尤其是在神经科学中。通过光控制神经元活动的能力使治疗策略得以发展,旨在在失明的视网膜条件下恢复一定程度的视力。有希望的临床前和初步临床数据支持这种期望。在实现有用的视力恢复的道路上,仍有许多挑战需要解决(例如,安全性、细胞和电路特异性、刺激模式、强度和模式、康复计划的确认)。
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引用次数: 0
Innate Immunity in Type 1 Diabetes. 1 型糖尿病的先天免疫。
IF 7.8 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-07-29 DOI: 10.1101/cshperspect.a041595
Léo Bertrand, Alexander V Chervonsky, Agnès Lehuen

Type 1 diabetes (T1D) results from the destruction of pancreatic β cells by the immune system, to which both pancreatic β-cell dysfunction and pathological activation of the immune system contribute. This paper is focused on understanding the modalities of this activation, and the genetic and environmental factors increasing its risk. Innate immunity has a critical role in the loss of self-tolerance and promotion of inflammation either directly using innate effector mechanisms or by providing activation signals to anti-islet adaptive autoimmunity. We provide an overview of various deleterious and protective roles of innate immunity in T1D inside pancreatic islets, regional lymph nodes, and distant locations such as the gut.

1 型糖尿病(T1D)是免疫系统破坏胰腺 β 细胞的结果,胰腺 β 细胞功能障碍和免疫系统的病理激活都是导致该病的原因。本文的重点是了解这种激活的方式,以及增加其风险的遗传和环境因素。先天性免疫直接利用先天性效应机制或为抗胰岛适应性自身免疫提供激活信号,在丧失自身耐受性和促进炎症方面起着至关重要的作用。我们概述了先天性免疫在胰岛、区域淋巴结和肠道等远处的 T1D 中的各种有害和保护作用。
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引用次数: 0
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Cold Spring Harbor perspectives in medicine
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