1型糖尿病的精准医疗

IF 1.8 4区 综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES
Dominika A. Michalek, Suna Onengut-Gumuscu, David R. Repaske, Stephen S. Rich
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引用次数: 1

摘要

1型糖尿病是一种复杂的慢性疾病,其中胰腺中产生胰岛素的β细胞被充分改变或受损,导致生存需要外源性胰岛素。1型糖尿病的发展被认为是一个自身免疫过程,在遗传易感个体中,环境(未知)触发启动T细胞介导的免疫反应。血液中存在胰岛自身抗体是1型糖尿病发展的标志,发展为临床1型糖尿病的风险与多种胰岛自身抗体的存在相关。目前,1型糖尿病的“分期”模型提出了由正常血糖但至少有两种胰岛自身抗体(第1阶段)、血糖异常但至少有两种胰岛自身抗体(第2阶段)和临床诊断(第3阶段)组成的离散组成部分。虽然这些阶段实际上可能不是离散的,而且因人而异,但这种形式表明了精准医学在诊断、预防、预后、治疗和监测方面的重要应用。本文讨论了精准医疗在1型糖尿病中的应用,并强调了全球实施的机遇和障碍。一些研究小组已经实施了精准医疗的组成部分,然而,为了实现短期和长期的解决方案,整合必要的步骤将需要研究人员、患者、家庭和医疗保健提供者的参与,以充分影响和减轻1型糖尿病的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Precision Medicine in Type 1 Diabetes

Precision Medicine in Type 1 Diabetes

Type 1 diabetes is a complex, chronic disease in which the insulin-producing beta cells in the pancreas are sufficiently altered or impaired to result in requirement of exogenous insulin for survival. The development of type 1 diabetes is thought to be an autoimmune process, in which an environmental (unknown) trigger initiates a T cell-mediated immune response in genetically susceptible individuals. The presence of islet autoantibodies in the blood are signs of type 1 diabetes development, and risk of progressing to clinical type 1 diabetes is correlated with the presence of multiple islet autoantibodies. Currently, a “staging” model of type 1 diabetes proposes discrete components consisting of normal blood glucose but at least two islet autoantibodies (Stage 1), abnormal blood glucose with at least two islet autoantibodies (Stage 2), and clinical diagnosis (Stage 3). While these stages may, in fact, not be discrete and vary by individual, the format suggests important applications of precision medicine to diagnosis, prevention, prognosis, treatment and monitoring. In this paper, applications of precision medicine in type 1 diabetes are discussed, with both opportunities and barriers to global implementation highlighted. Several groups have implemented components of precision medicine, yet the integration of the necessary steps to achieve both short- and long-term solutions will need to involve researchers, patients, families, and healthcare providers to fully impact and reduce the burden of type 1 diabetes.

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来源期刊
Journal of the Indian Institute of Science
Journal of the Indian Institute of Science MULTIDISCIPLINARY SCIENCES-
CiteScore
4.30
自引率
0.00%
发文量
75
期刊介绍: Started in 1914 as the second scientific journal to be published from India, the Journal of the Indian Institute of Science became a multidisciplinary reviews journal covering all disciplines of science, engineering and technology in 2007. Since then each issue is devoted to a specific topic of contemporary research interest and guest-edited by eminent researchers. Authors selected by the Guest Editor(s) and/or the Editorial Board are invited to submit their review articles; each issue is expected to serve as a state-of-the-art review of a topic from multiple viewpoints.
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