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Sci Immunol:I型糖尿病最早生物标记物或被发现,有助于延缓疾病发作

2019-09-03 杜姝 生物探索

I型糖尿病,又被称为“青少年糖尿病”,是通常在20岁前出现的一种自身免疫性疾病。先前研究表明,该病发生是由于免疫系统破坏胰腺中β细胞制造胰岛素的能力。而待患者被确诊时,该疾病已潜伏发作一段时间了

I型糖尿病,又被称为“青少年糖尿病”,是通常在20岁前出现的一种自身免疫性疾病。先前研究表明,该病发生是由于免疫系统破坏胰腺中β细胞制造胰岛素的能力。而待患者被确诊时,该疾病已潜伏发作一段时间了。

是否有一种方法可以尽早发现高风险患者的患病迹象,从而预防或延迟发病呢?

近日发表在《Science Immunology》杂志上的一项最新研究报告称,来自美国斯克里普斯研究中心的科学家们或许已经找到了最早可检测I型糖尿病发病的生物学标记物,将大大改善潜在致病患者的治疗干预时间,推迟发病时间。

突变HLA蛋白+胰岛素片段=免疫系统破坏

1974年,发表在《THE LANCET》上的一项对I型糖尿病来说具有里程碑意义的遗传学研究揭开了其神秘的面纱,研究学者发现:在患有I型糖尿病的患者中,HLAs(人类白细胞抗原)这类免疫调节分子中总存在着独特的遗传特征。

HLA蛋白质往往位于细胞表面,是免疫系统是否发起攻击的“通信员”。但当它“传错信”时,后果往往很严重,小则生病大则危及生命。而I型糖尿病的产生便也来源于这样的“传错信”:突变的HLA蛋白与β细胞产生的胰岛素片段结合后导致免疫系统破坏,从而阻止葡萄糖进入细胞,将其集聚在血液中,导致高血糖的产生。

25年过去了,科学家们发现虽然建立了HLA基因突变与I型糖尿病之间的联系,但仍然无法辨别免疫系统的T细胞究竟是如何被“吸引”到这一疾病上的。

单细胞测序找到最早遗传生物标记

基于这一问题,来自美国Scripps Research的Luc Teyton博士及其团队通过5年的潜心专研,给出了最新的回答。让该研究发生质的飞越是来自多次对这类的细胞进行的单细胞测序和分析。研究团队与同一研究中心的综合结构和计算生物学系合作,对单个T细胞的DNA进行了测序,获得了极高分辨率的细胞功能和遗传变异视图。

在雌性NOD小鼠的疾病过程中胰岛中的抗胰岛素特异性群体动态。

从这一高清视图中,他们发现了一种被其称为“P9开关”的细胞结构机制。这一机制允许CD4 + T细胞识别突变的HLA蛋白并攻击β细胞。还值得注意的是,P9开关在小鼠中引发了早期的抗胰岛素反应,然后迅速消失。如果这种现象也在人类研究中出现,也就意味着这些配备“P9开关”的细胞将成为识别发病的早期生物标记。

目前,Teyton团队已获批准备向人类展开进一步的研究。研究人员将在每年收集多达30名I型糖尿病高危人群的血液样本,并对这些血液样本进行分析以找寻人类患者发病前兆生物标记是否与“P9开关”的细胞结构机制相关。

该论文的第一作者Luc Teyton博士表示,由于I型糖尿病具有很强的遗传联系,因此因遗传致病的患病风险要比首次获病的风险高出20倍之多。所以,我们亟需一个明确的生物标记来帮助其预防或延迟发病。

原始出处:
Gioia L1, Holt M2, Costanzo A2, et al.Position β57 of I-Ag7 controls early anti-insulin responses in NOD mice, linking an MHC susceptibility allele to type 1 diabetes onset.Sci Immunol. 2019 Aug 30;4(38). pii: eaaw6329. doi: 10.1126/sciimmunol.aaw6329.

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    2020-01-21 wjywjy
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    2019-09-03 misszhang

    谢谢MedSci提供最新的资讯

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真实世界的数据支持赛诺菲的Toujeo用于I型糖尿病

赛诺菲公布了来自英国真实世界的研究数据,显示其长效基础胰岛素类似物Toujeo在治疗I型糖尿病患者中的功效。这些数据首次在芝加哥内分泌协会第100届年会暨博览会ENDO 2018上发布,表明该药物与患有该病症的患者的HbA1c的显着改善,具有统计学意义,平均差异从基线至六个月的-4.4毫摩尔/摩尔。该研究还显示,在Toujeo(Gla-300)开始治疗后报告糖尿病酮症酸中毒(DKA)或严重低血糖的

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