犬 1 型糖尿病的治疗:从每日两次注射胰岛素到长效细胞疗法的漫长之路

Organoids Pub Date : 2024-04-04 DOI:10.3390/organoids3020006
Flavia C. M. Oliveira, A. Voorbij, Elisa C. Pereira, Leonor M. M. Alves e Almeida, Geanne R. Moraes, Joana T. De Oliveira, Boyd H. T. Gouw, Sabrina A. M. Legatti, Hans S. Kooistra, B. Spee, Andre M. C. Meneses, Louis C. Penning
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摘要

150 多年来,研究人员一直在研究胰腺内分泌的(病理)生理学,并设计出糖尿病(DM)的治疗方案。然而,迄今为止还没有找到治疗方法。在狗身上,1 型糖尿病(T1DM)是最常见的表现。治疗方法包括每天注射两次胰岛素,并通过空间血糖测量进行监测。尽管狗在胰岛素和胰岛移植的发现过程中发挥了重要作用,但几十年来,糖尿病狗的治疗方法一直没有改变。每天注射两次胰岛素对主人和狗的要求都很高,而且可能导致低血糖事件,因此需要新的治疗策略。以再生医学为基础的新型工具,如改进的β细胞培养方案和人工设备,为治愈糖尿病带来了希望。在人类医学领域,一些新兴技术,如移植干细胞分化产生的胰岛素分泌β细胞,无论是否使用封装装置,目前都在进行I/II期临床试验。由于 T1DM 的发病机理在人类和犬类之间非常相似,新的治疗方法可以在犬类医学中应用。本综述简要概述了犬内分泌胰腺的生理学和犬 DM 的病理生理学,然后探讨了犬 DM 目前和未来可能的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of Canine Type 1 Diabetes Mellitus: The Long Road from Twice Daily Insulin Injection towards Long-Lasting Cell-Based Therapy
For over 150 years, researchers have studied the (patho)physiology of the endocrine pancreas and devised treatment options for diabetes mellitus (DM). However, no cure has been developed so far. In dogs, diabetes mellitus type 1 (T1DM) is the most common presentation. Treatment consists of twice daily insulin injections, monitored by spatial blood glucose measurements. Even though dogs were instrumental in the discovery of insulin and islet transplantations, the treatment in diabetic dogs has remained unchanged for decades. Providing twice daily insulin injections is demanding for both owners and dogs and may result in hypoglycaemic events, creating the need for new treatment strategies. Novel regenerative medicine-based tools, such as improved β-cell culture protocols and artificial devices, have sparked hope for a cure. In human medicine, emerging technologies such as the transplantation of insulin-producing β-cells, generated by stem cell differentiation, with or without an encapsulation device, are currently tested in phase I/II clinical trials. As the pathogenesis of T1DM is remarkably similar between humans and dogs, novel treatment methods could be implemented in canine medicine. This review briefly summarises the physiology of the canine endocrine pancreas and the pathophysiology of canine DM before exploring current and possible future treatment options for canine DM.
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