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Telling Your Research Story. 讲述你的研究故事
Pub Date : 2024-01-01
Houmam Araj
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引用次数: 0
A Natural Metabolite and Inhibitor of the NLRP3 Inflammasome: 4-hydroxynonenal. 一种天然代谢物和 NLRP3 炎症体抑制剂:4-羟基壬烯醛
Pub Date : 2024-01-01 DOI: 10.33696/immunology.6.192
Jinmin Zhang, Bradford C Berk, Chia George Hsu

The NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome, crucial in the innate immune response, is linked to various human diseases. However, the effect of endogenous metabolites, like 4-hydroxynonenal (HNE), on NLRP3 inflammasome activity remains underexplored. Recent research highlights HNE's inhibitory role in NLRP3 inflammasome activation, shedding light on its potential as an endogenous regulator of inflammatory responses. Studies demonstrate that HNE blocks NLRP3 inflammasome-mediated pyroptosis and IL-1β secretion. Additionally, covalent targeting emerges as a common mechanism for inhibiting NLRP3 inflammasome assembly, offering promising avenues for therapeutic intervention. Further investigation is needed to understand the impact of endogenous HNE on NLRP3 inflammasome activation, especially in settings where lipid peroxidation byproducts like HNE are produced. Understanding the intricate interplay between HNE and the NLRP3 inflammasome holds significant potential for unraveling novel therapeutic strategies for inflammatory disorders.

NOD-、LRR-和含吡咯啉结构域的蛋白 3(NLRP3)炎性组在先天性免疫反应中至关重要,它与多种人类疾病有关。然而,4-羟基壬烯醛(HNE)等内源性代谢物对 NLRP3 炎症小体活性的影响仍未得到充分探索。最近的研究强调了 HNE 在 NLRP3 炎症小体激活过程中的抑制作用,揭示了其作为炎症反应内源性调节剂的潜力。研究表明,HNE 可阻断 NLRP3 炎性体介导的脓毒症和 IL-1β 的分泌。此外,共价靶向是抑制 NLRP3 炎症小体组装的常见机制,为治疗干预提供了很好的途径。要了解内源性 HNE 对 NLRP3 炎症小体活化的影响,尤其是在产生 HNE 等脂质过氧化副产物的情况下,还需要进一步的研究。了解 HNE 与 NLRP3 炎症小体之间错综复杂的相互作用,对于揭示炎症性疾病的新型治疗策略具有重大潜力。
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引用次数: 0
Evaluating the Role of the Renin-angiotensin System in COVID-19: Implications for ACE Inhibitor and ARB Use During SARS-CoV-2 Infection. 评估肾素-血管紧张素系统在COVID-19中的作用:对SARS-CoV-2感染期间ACE抑制剂和ARB使用的影响
Pub Date : 2024-01-01 DOI: 10.33696/immunology.6.213
Sarah R Tritsch, Evelyn Mendoza-Torres, Mónica Gómez-Pulido, Jairo Castellar-López, Rebecca Lynch, Carlos Herrera Gomez, Hana Akselrod, Adrienne Poon, Sam Simmens, Christopher N Mores, Gary Simon, Lauren C Ray, Sarah Conway, Aileen Y Chang

This study aimed to investigate the role of the renin-angiotensin system (RAS) in COVID-19, particularly focusing on key components such as ACE, ACE2, and their related peptides, angiotensin-(1-7) and angiotensin-(1-9). Using serum samples from healthy controls and both non-severe and severe COVID-19 patients, ELISA assays revealed no significant differences in these RAS components between the groups. In addition, in vitro studies showed no impact of ACE inhibitors or Angiotensin Receptor Blockers (ARB) on cell viability during SARS-CoV-2 infection. These clinical findings suggest that RAS alterations may not be a major factor in COVID-19 severity and the in vitro data support current guidelines, indicating the safety of continuing ACE inhibitors and ARBs in COVID-19 patients without evidence of increased SARS-CoV-2 infectivity in the presence of these compounds. This study highlights the lack of significant changes in key RAS components during COVID-19 in a clinical cohort and provides critical in vitro evidence supporting the continued use of ACE inhibitors and ARBs in treating patients.

本研究旨在探讨肾素-血管紧张素系统(RAS)在COVID-19中的作用,重点关注ACE、ACE2及其相关肽、血管紧张素-(1-7)和血管紧张素-(1-9)等关键成分。使用健康对照者以及非重症和重症COVID-19患者的血清样本,ELISA检测显示,这些RAS成分在两组之间没有显著差异。此外,体外研究显示,在SARS-CoV-2感染期间,ACE抑制剂或血管紧张素受体阻滞剂(ARB)对细胞活力没有影响。这些临床研究结果表明,RAS改变可能不是COVID-19严重程度的主要因素,体外数据支持现行指南,表明持续使用ACE抑制剂和arb对COVID-19患者是安全的,没有证据表明存在这些化合物会增加SARS-CoV-2的传染性。该研究强调了临床队列中关键RAS成分在COVID-19期间缺乏显着变化,并提供了支持继续使用ACE抑制剂和arb治疗患者的关键体外证据。
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引用次数: 0
Epidemiology, Symptoms and Pathophysiology of Long Covid Complications. 长冠并发症的流行病学、症状和病理生理学
Pub Date : 2024-01-01 DOI: 10.33696/immunology.6.209
Chongyang Zhang, Chiung-Yu Hung, Chia George Hsu

Long COVID, or post-acute sequelae of SARS-CoV-2 infection, reports to affect a significant proportion of COVID-19 survivors, leading to persistent and multi-organ complications. This review examines the epidemiology, symptoms of long COVID complications, including cardiac, hematological, vascular, pulmonary, neuropsychiatric, renal, gastrointestinal, musculoskeletal, immune dysregulation, and dermatological issues. By synthesizing the latest research, this article provides a comprehensive overview of the prevalence and detailed pathophysiological mechanisms underlying these complications. The purpose of this review is to enhance the understanding of diverse and complex nature of long COVID and emphasize the need for ongoing research, seeking to support future studies for better management of long COVID.

据报道,长冠状病毒或SARS-CoV-2感染的急性后后遗症会影响很大比例的COVID-19幸存者,导致持续的多器官并发症。本文综述了流行病学和长期COVID并发症的症状,包括心脏、血液、血管、肺、神经精神、肾脏、胃肠道、肌肉骨骼、免疫失调和皮肤病学问题。通过综合最新研究,本文对这些并发症的患病率和详细的病理生理机制进行了全面的综述。本综述的目的是加强对长冠状病毒病的多样性和复杂性的理解,并强调持续研究的必要性,寻求支持未来更好地管理长冠状病毒病的研究。
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引用次数: 0
Essentials of CAR-T Therapy and Associated Microbial Challenges in Long Run Immunotherapy. CAR-T 疗法要点及长期免疫疗法中的相关微生物挑战。
Pub Date : 2024-01-01 DOI: 10.33696/immunology.6.189
Muhammad Kalim, Rui Jing, Xin Li, Zhiwu Jiang, Ningbo Zheng, Ziyu Wang, Guo Wei, Yong Lu

Chimeric antigen receptor (CAR)-T cell therapy has shown potential in improving outcomes for individuals with hematological malignancies. However, achieving long-term full remission for blood cancer remains challenging due to severe life-threatening toxicities such as limited anti-tumor efficacy, antigen escape, trafficking restrictions, and limited tumor invasion. Furthermore, the interactions between CAR-T cells and their host tumor microenvironments have a significant impact on CAR-T function. To overcome these considerable hurdles, fresh methodologies and approaches are needed to produce more powerful CAR-T cells with greater anti-tumor activity and less toxicity. Despite advances in CAR-T research, microbial resistance remains a significant obstacle. In this review, we discuss and describe the basics of CAR-T structures, generations, challenges, and potential risks of infections in CAR-T cell therapy.

嵌合抗原受体(CAR)-T 细胞疗法已显示出改善血液恶性肿瘤患者预后的潜力。然而,由于存在严重的危及生命的毒性,如有限的抗肿瘤疗效、抗原逃逸、贩运限制和有限的肿瘤侵袭,实现血癌的长期完全缓解仍具有挑战性。此外,CAR-T 细胞与其宿主肿瘤微环境之间的相互作用对 CAR-T 的功能也有重大影响。为了克服这些巨大的障碍,我们需要新的方法和途径来生产出抗肿瘤活性更强、毒性更小的 CAR-T 细胞。尽管 CAR-T 研究取得了进展,但微生物抗药性仍是一个重大障碍。在这篇综述中,我们将讨论并介绍 CAR-T 结构、世代、挑战以及 CAR-T 细胞疗法中感染的潜在风险等基本知识。
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引用次数: 0
Evaluation of Neutrophil Elastase Inhibitors as Potential Therapies for ELANE Associated Neutropenia. 将中性粒细胞弹性蛋白酶抑制剂作为治疗 ELANE 相关性中性粒细胞减少症的潜在疗法进行评估。
Pub Date : 2024-01-01 DOI: 10.33696/immunology.6.208
Vahagn Makaryan, Merideth Kelley, Audrey Anna Bolyard, Gobind Chugh, David C Dale

Neutrophil elastase (ELANE) mutations are the most common cause of cyclic (CyN) and congenital neutropenia (SCN), two autosomal dominant disorders causing recurrent infections due to impaired neutrophil production. Granulocyte colony-stimulating factor (G-CSF) corrects neutropenia but has adverse effects, including bone pain and in some cases, an increased risk of myelodysplasia (MDS) and acute myeloid leukemia (AML). Hematopoietic stem cell transplantation is an alternative but is limited by its complications and donor availability. Alternative therapies are needed, particularly for patients with poor responses to G-CSF and those at higher risk of MDS/AML. We previously reported that cell-permeable neutrophil elastase (NE) inhibitors are a potential treatment for ELANE neutropenia, based on studies using HL-60 cells. Our hypothesis was that mutant NE was not properly stored to the neutrophil granules and thereby caused cytoplasmic damage, activation of apoptotic pathways and neutropenia. We have extended this work using CD34+ cells from patients with ELANE mutations and several selective NE inhibitors, i.e., MK0339, sivelestat, BAY-678, and GW311616, as well as the DDP1 inhibitor, brensocatib. Only MK0339 restored neutrophil differentiation with an increase in the proportion of neutrophil marker-positive cells (CD66b+/CD14+ and CD11b+/CD15+). In contrast, other NE inhibitors, i.e., sivelestat, BAY-678, and GW311616 and the DPP1 inhibitor, brensocatib, showed no effect on neutrophil differentiation. Molecular docking studies showed that MK0339 binds to an alternative site on the NE protein compared to other inhibitors with greater inhibitor-NE protein stability, suggesting a unique mechanism of action and supporting further investigation of MK0339 as a therapy for ELANE associated neutropenia.

中性粒细胞弹性蛋白酶(ELANE)突变是导致周期性中性粒细胞减少症(CyN)和先天性中性粒细胞减少症(SCN)的最常见原因。粒细胞集落刺激因子(G-CSF)可纠正中性粒细胞减少症,但有不良反应,包括骨痛,在某些情况下还会增加骨髓增生异常(MDS)和急性髓性白血病(AML)的风险。造血干细胞移植是一种替代疗法,但受到并发症和供体供应的限制。我们需要替代疗法,尤其是对G-CSF反应不佳的患者和MDS/AML风险较高的患者。我们以前曾报道过,基于使用 HL-60 细胞进行的研究,细胞渗透性中性粒细胞弹性蛋白酶(NE)抑制剂是治疗 ELANE 中性粒细胞减少症的一种潜在疗法。我们的假设是,突变的 NE 无法正常储存到中性粒细胞颗粒中,从而导致细胞质损伤、凋亡途径激活和中性粒细胞减少症。我们利用 ELANE 突变患者的 CD34+ 细胞和几种选择性 NE 抑制剂(即 MK0339、sivelestat、BAY-678 和 GW311616,以及 DDP1 抑制剂 brensocatib)扩展了这项工作。只有 MK0339 能恢复中性粒细胞的分化,使中性粒细胞标记阳性细胞(CD66b+/CD14+ 和 CD11b+/CD15+)的比例增加。相比之下,其他 NE 抑制剂(即西维司他、BAY-678 和 GW311616)和 DPP1 抑制剂 brensocatib 对中性粒细胞分化没有影响。分子对接研究表明,与其他抑制剂相比,MK0339 与 NE 蛋白上的另一个位点结合,抑制剂-NE 蛋白的稳定性更高,这表明它具有独特的作用机制,支持进一步研究 MK0339 作为 ELANE 相关中性粒细胞减少症的疗法。
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引用次数: 0
The Natural History of Post-Chikungunya Viral Arthritis Disease Activity and T-cell Immunology: A Cohort Study. 基孔肯雅病毒性关节炎后疾病活动和 T 细胞免疫学的自然史:队列研究
Pub Date : 2024-01-01 DOI: 10.33696/immunology.6.191
Aileen Yu-Hen Chang, Alfonso Sucerquia Hernández, Jose Forero Mejía, Sarah Renee Tritsch, Evelyn Mendoza-Torres, Liliana Encinales, Andres Cadena Bonfanti, Abigale Marie Proctor, Gary Leonard Simon, Samuel Joseph Simmens, Gary Steven Firestein

Background: Chikungunya virus (CHIKV) is an alphavirus spread by mosquitos that causes arthralgias and arthritis that may last for years. The objective of this study was to describe the arthritis progression and T cell immunology over a two-year period.

Methods: A cohort of 40 cases of serologically confirmed CHIKV from Magdalena and Atlántico, Colombia were followed in 2019 and again in 2021. Arthritis disease severity, disability, pain, stiffness, physical function, mobility, fatigue, anxiety, sleep disturbances and depression were assessed. Serum cytokines and T-cell subsets were measured and tested for change. Correlations within each of the 2 time periods for laboratory parameters were also examined.

Results: Although, arthritis disease severity, as measured by the Disease Activity Score-28 (DAS-28) did not change significantly over a two-year period, a new metric- the Chikungunya Disease Activity Score (CHIK-DAS)- was more sensitive to detect changes in disease severity than the Disease Activity Score-28 (DAS-28) and showed some improvement in average disease severity from moderate to mild over two years. Cases were characterized by moderate disability, pain, and stiffness with mild alterations of physical function, mobility, fatigue, anxiety, sleep disturbances and depression that did not change significantly over time. Small joints including the fingers and wrists were most affected without significant change over time. The percentage of effector T cells (Teffs) and regulatory T cells (Tregs) of CD4+ T cells both decreased over time. Teff percentages decreased more significantly resulting in a halving of the Teff/Treg ratio two years later. Furthermore, markers of Treg immunosuppressive function such as CTLA4, Helios, CD28, CD45RA and 41bb decreased over time. Cytokines did not change significantly over time.

Conclusions: The presented data suggest that arthritis persists almost seven years after chikungunya infection in some patients with waning Teff and Treg numbers and activation markers over time. Treg activation may be a promising therapeutic target for further investigation.

背景:基孔肯雅病毒(CHIKV)是一种通过蚊子传播的α病毒,可引起关节痛和关节炎,并可持续数年。本研究的目的是描述两年内关节炎的进展和 T 细胞免疫学:方法:对来自哥伦比亚马格达莱纳和阿特兰蒂科的 40 例经血清学确诊的 CHIKV 病例于 2019 年和 2021 年进行了追踪调查。对关节炎疾病严重程度、残疾、疼痛、僵硬、身体功能、活动能力、疲劳、焦虑、睡眠障碍和抑郁进行了评估。对血清细胞因子和 T 细胞亚群进行了测量并检测其变化。此外,还研究了两个时间段内实验室参数的相关性:尽管以疾病活动度评分-28(DAS-28)衡量的关节炎疾病严重程度在两年内没有显著变化,但一种新的衡量标准--基孔肯雅病疾病活动度评分(CHIK-DAS)--在检测疾病严重程度变化方面比疾病活动度评分-28(DAS-28)更敏感,并显示两年内平均疾病严重程度从中度到轻度有了一些改善。病例以中度残疾、疼痛和僵硬为特征,身体功能、活动能力、疲劳、焦虑、睡眠障碍和抑郁均有轻度改变,且随时间推移无明显变化。包括手指和手腕在内的小关节受影响最严重,但随时间推移无明显变化。CD4+ T 细胞中效应 T 细胞(Teffs)和调节 T 细胞(Tregs)的百分比均随时间推移而下降。Teff 百分比的下降更为明显,导致两年后 Teff/Treg 比率减半。此外,Treg 免疫抑制功能的标志物,如 CTLA4、Helios、CD28、CD45RA 和 41bb 也随着时间的推移而减少。细胞因子随时间变化不大:本文提供的数据表明,一些患者在感染基孔肯雅病毒近 7 年后仍存在关节炎,Teff 和 Treg 的数量和活化标志物随着时间的推移不断减少。Treg激活可能是一个很有希望的治疗靶点,有待进一步研究。
{"title":"The Natural History of Post-Chikungunya Viral Arthritis Disease Activity and T-cell Immunology: A Cohort Study.","authors":"Aileen Yu-Hen Chang, Alfonso Sucerquia Hernández, Jose Forero Mejía, Sarah Renee Tritsch, Evelyn Mendoza-Torres, Liliana Encinales, Andres Cadena Bonfanti, Abigale Marie Proctor, Gary Leonard Simon, Samuel Joseph Simmens, Gary Steven Firestein","doi":"10.33696/immunology.6.191","DOIUrl":"10.33696/immunology.6.191","url":null,"abstract":"<p><strong>Background: </strong>Chikungunya virus (CHIKV) is an alphavirus spread by mosquitos that causes arthralgias and arthritis that may last for years. The objective of this study was to describe the arthritis progression and T cell immunology over a two-year period.</p><p><strong>Methods: </strong>A cohort of 40 cases of serologically confirmed CHIKV from Magdalena and Atlántico, Colombia were followed in 2019 and again in 2021. Arthritis disease severity, disability, pain, stiffness, physical function, mobility, fatigue, anxiety, sleep disturbances and depression were assessed. Serum cytokines and T-cell subsets were measured and tested for change. Correlations within each of the 2 time periods for laboratory parameters were also examined.</p><p><strong>Results: </strong>Although, arthritis disease severity, as measured by the Disease Activity Score-28 (DAS-28) did not change significantly over a two-year period, a new metric- the Chikungunya Disease Activity Score (CHIK-DAS)- was more sensitive to detect changes in disease severity than the Disease Activity Score-28 (DAS-28) and showed some improvement in average disease severity from moderate to mild over two years. Cases were characterized by moderate disability, pain, and stiffness with mild alterations of physical function, mobility, fatigue, anxiety, sleep disturbances and depression that did not change significantly over time. Small joints including the fingers and wrists were most affected without significant change over time. The percentage of effector T cells (Teffs) and regulatory T cells (Tregs) of CD4<sup>+</sup> T cells both decreased over time. Teff percentages decreased more significantly resulting in a halving of the Teff/Treg ratio two years later. Furthermore, markers of Treg immunosuppressive function such as CTLA4, Helios, CD28, CD45RA and 41bb decreased over time. Cytokines did not change significantly over time.</p><p><strong>Conclusions: </strong>The presented data suggest that arthritis persists almost seven years after chikungunya infection in some patients with waning Teff and Treg numbers and activation markers over time. Treg activation may be a promising therapeutic target for further investigation.</p>","PeriodicalId":73644,"journal":{"name":"Journal of cellular immunology","volume":"6 2","pages":"64-75"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11172407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Polyamines: Key Players in Immunometabolism and Immune Regulation. 多胺:免疫代谢和免疫调节的关键角色。
Pub Date : 2024-01-01 DOI: 10.33696/immunology.6.206
Shanmuga S Mahalingam, Pushpa Pandiyan

Polyamines are small organic molecules ubiquitously present in all living organisms and function as crucial regulators of biological processes ranging from fundamental cellular metabolism to immune regulation. Dysregulation of polyamine metabolism has been implicated in numerous diseases, including neurodegenerative disorders, inflammatory conditions, autoimmune diseases, and cancer. This review provides an overview of pathophysiology of these conditions, highlighting polyamines' role in immunometabolic alterations in the context of immune regulation. Exploring the intricate mechanisms of polyamine metabolism holds promise for advancing our understanding of disease processes and developing potential innovative therapeutic interventions.

多胺是一种小的有机分子,普遍存在于所有生物体中,在从基本细胞代谢到免疫调节等生物过程中起着至关重要的调节作用。多胺代谢失调与许多疾病有关,包括神经退行性疾病、炎症、自身免疫性疾病和癌症。这篇综述综述了这些疾病的病理生理学,强调了多胺在免疫调节背景下免疫代谢改变中的作用。探索多胺代谢的复杂机制有望促进我们对疾病过程的理解,并开发潜在的创新治疗干预措施。
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引用次数: 0
Can Vaccines Stop Cancer Before It Starts? Assessing the Promise of Prophylactic Immunization Against High-Risk Preneoplastic Lesions 疫苗能否防癌于未然?评估高风险癌前病变预防性免疫的前景
Pub Date : 2023-11-29 DOI: 10.33696/immunology.5.178
T. Addissouky, Ibrahim El Tantawy El Sayed, Majeed M. A. Ali, Yuliang Wang, Ayman El Baz, Ahmed A. Khalil, N. Elarabany
Background: Cancer remains a leading cause of mortality with modest declines, highlighting the need for more efficacious prevention strategies like early immunological intervention against premalignant disease. Main body of abstract: Oncogenic viruses demonstrate prophylactic vaccines can successfully reduce malignancy by blocking precipitating infections. However, most cancers lack viral etiology, requiring novel approaches targeting sporadic precancerous states to enable early immunoprevention. Preneoplastic tissues exhibit biological changes making them appealing targets for stimulating immune surveillance before additional mutations cause unconstrained proliferation. High-risk precancers also provide sources of dysregulated self-antigens. Yet challenges exist in lesion identification, overcoming tolerance, and avoiding inflammation potentially worsening progression. Multidisciplinary insights into precancer immunology, predictive biomarkers, antigen discovery, and combinatorial vaccination strategies are illuminating rational vaccine design. Despite obstacles, prophylactic immunization against early dysplastic changes holds disruptive potential if key steps advance this approach. Elucidating preneoplasia immunobiology and progression risk modeling will be critical to guide productive immune targeting while mitigating immunotherapy hazards. Thoughtful translation could eventually shift paradigms by priming immunosurveillance against peak vulnerability lesions. Short Conclusion: Advancements in precancer vaccines may profoundly expand prevention horizons. Cautious immune targeting of premalignant states could intercept progression toward widely disseminated malignancies. This warrants methodical efforts to unravel the promise of thwarting lethal cancers before they start.
背景:癌症仍然是导致死亡的主要原因之一,但其死亡率下降幅度不大,这突出表明需要更有效的预防策略,如针对恶性肿瘤前疾病的早期免疫干预。 摘要正文:致癌病毒表明,预防性疫苗可通过阻断诱发感染成功减少恶性肿瘤。然而,大多数癌症缺乏病毒病因,因此需要针对零星癌前状态的新方法来实现早期免疫预防。癌前组织表现出的生物变化使其成为在额外突变导致无限制增殖之前刺激免疫监视的有吸引力的目标。高风险癌前病变还提供了失调的自身抗原来源。然而,在病变识别、克服耐受性和避免炎症可能导致病情恶化方面还存在挑战。对癌前病变免疫学、预测性生物标记物、抗原发现和组合疫苗接种策略等多学科的深入研究,为合理的疫苗设计提供了启示。尽管存在障碍,但如果能采取关键步骤推进这一方法,针对早期发育不良变化的预防性免疫接种将具有颠覆性的潜力。阐明肿瘤前期免疫生物学和进展风险建模对于指导富有成效的免疫靶向治疗同时减轻免疫疗法的危害至关重要。经过深思熟虑的转化最终可以通过针对高峰易感病变启动免疫监视来改变模式。 简短结论:癌前病变疫苗的进步可能会极大地扩展预防范围。针对癌前状态的谨慎免疫可以阻止恶性肿瘤向广泛传播的方向发展。这就需要我们有条不紊地努力,在致命癌症发生之前就将其扼杀在摇篮里。
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引用次数: 0
Type 1 Diabetes: A Disorder of the Exocrine and Endocrine Pancreas 1 型糖尿病:胰腺外分泌和内分泌失调
Pub Date : 2023-11-24 DOI: 10.33696/immunology.5.177
Brittany S. Bruggeman, Desmond A. Schatz
Type 1 diabetes has historically been described as an endocrine (β-cell) specific autoimmune disease. However, a substantial reduction (20-50%) in pancreas organ size and subclinical to symptomatic exocrine pancreatic insufficiency are present at diagnosis and may begin even prior to the development of islet autoimmunity. The mechanisms of exocrine loss in type 1 diabetes are not well understood, but leading hypotheses include developmental defects, β-cell loss resulting in exocrine atrophy, or autoimmune or inflammatory destruction of exocrine cells. Inflammatory changes including acute and chronic pancreatitis, exocrine T cell infiltration and classical complement activation, and serum exocrine autoantibodies within type 1 diabetes individuals suggest that an autoimmune or inflammatory process may contribute to exocrine pancreatic dysfunction. Exocrine pancreas atrophy primarily occurs prior to the onset of clinical disease. Indeed, recent work implicates exocrine-specific alterations in gene and protein expression as key in type 1 diabetes development. Measures of exocrine size and function could be useful additions in the prediction of disease onset and in identifying potential therapeutic responders to disease therapies, however, this is an underdeveloped area of research. Additionally, exocrine pancreatic insufficiency is underdiagnosed in individuals with type 1 diabetes and individualized treatment protocols are lacking. Much work remains to be done in this area, but we can definitively say that type 1 diabetes is a disorder of both the exocrine and endocrine pancreas likely from the start.
1 型糖尿病历来被描述为一种内分泌(β 细胞)特异性自身免疫疾病。然而,胰腺器官大小的大幅缩小(20%-50%)以及亚临床或无症状的胰腺外分泌功能不全在诊断时就已存在,甚至可能在胰岛自身免疫发生之前就已开始。1 型糖尿病外分泌功能丧失的机制尚不十分清楚,但主要假说包括发育缺陷、β 细胞丧失导致外分泌萎缩,或外分泌细胞的自身免疫或炎症破坏。炎症变化包括急性和慢性胰腺炎、胰腺外分泌 T 细胞浸润和典型补体激活,以及 1 型糖尿病患者血清中的胰腺外分泌自身抗体,这表明自身免疫或炎症过程可能导致胰腺外分泌功能障碍。胰腺外分泌萎缩主要发生在临床发病之前。事实上,最近的研究表明,胰腺外分泌特异性基因和蛋白表达的改变是 1 型糖尿病发病的关键。测量胰腺外分泌的大小和功能可作为有用的补充,用于预测疾病的发病和识别潜在的疾病疗法应答者,然而,这是一个尚未充分开发的研究领域。此外,1 型糖尿病患者的胰腺外分泌功能不全诊断不足,缺乏个性化治疗方案。在这一领域仍有许多工作要做,但我们可以明确地说,1 型糖尿病很可能从一开始就是胰腺外分泌和内分泌失调。
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引用次数: 0
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Journal of cellular immunology
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