坎格列净治疗2型糖尿病的研究

目前糖尿病患病人数与日俱增,传统的降糖药物在治疗糖尿病时仍有一定的局限性。新型降糖药物不断出现,坎格列净作为新型降糖药物,为糖尿病的治疗提供了新的选择。本文通过查阅近年来国内外关于坎格列净治疗2型糖尿病的相关文献,对其作用机制、药代动力学、临床应用疗效、安全性等方面进行综述,为坎格列净治疗2型糖尿病的临床应用提供参考。     

干细胞移植治疗糖尿病

背景：干细胞移植可以从细胞和基因水平治疗糖尿病,从而达到临床治愈。 目的：综述近年来国内外干细胞移植治疗糖尿病的相关研究进展。 方法：应用计算机检索2000-01/2010-06 PubMed数据库、中国期刊全文数据库相关文章,检索词为“stem cells,diabetes mellitus,transplantation,insulin-secreting cell,treatment;干细胞,糖尿病,移植,胰岛素分泌细胞,治疗”,共纳入27篇文章进行综述。 结果与结论：糖尿病是一组由于胰岛素绝对或相对不足所引起的以慢性高血糖为特征的代谢性疾病,目前尚无根治的方法。干细胞具有极强的自我更新和多向分化潜能,可诱导分化为胰岛素分泌细胞,在体内和体外发挥调节血糖的作用,成为胰岛β细胞替代物的新资源。目前干细胞移植治疗糖尿病已在动物实验和小规模临床研究中取得了一定成果。     

2型糖尿病的易感基因研究进展

2型糖尿病是一种多基因遗传的复杂疾病,基因型一表型之间关系错综复杂,迄今仍然未能确定2型糖尿病的致病基因.本文主要阐述近年来2型糖尿病易感基因主要研究成果.     

Aptamers: novel diagnostic and therapeutic tools for diabetes mellitus and metabolic diseases

Diabetes mellitus is one of the most common chronic diseases that threatens human health in worldwide populations. Despite enormous efforts invested in the study of diabetes mellitus, the development of precise diagnoses and treatments for this disease remains difficult due to the limitations of current techniques. Therefore, new methods are currently being developed. Aptamers are oligonucleotides that bind to specific target molecules and have been widely applied as diagnostic and therapeutic tools. In recent years, aptamers have been utilized in the study of diabetes mellitus and metabolic diseases. In this review, we highlight recent developments and new perspectives on aptamers in the field of diabetes mellitus and other metabolic diseases. Aptamers could potentially provide the means for efficient diagnoses and therapies against diabetes mellitus.     

线粒体基因突变与糖尿病相关性研究进展

糖尿病是一种常见的具有明显异质性的多基因遗传病,随着分子生物学技术的不断发展,近年来,人们发现糖尿病的发生与线粒体DNA分子的突变密切相关,许多突变位点已被相继发现,使得这一领域成为糖尿病分子生物遗传学研究的热点之一.本文就线粒体基因的遗传特性及其与糖尿病相关的突变位点方面的研究作一综述.     

Regulation of metabolic health and adipose tissue function by group 2 innate lymphoid cells

Adipose tissue (AT) is home to an abundance of immune cells. With chronic obesity, inflammatory immune cells accumulate and promote insulin resistance and the progression to type 2 diabetes mellitus. In contrast, recent studies have highlighted the regulation and function of immune cells in lean, healthy AT, including those associated with type 2 or “allergic” immunity. Although traditionally activated by infection with multicellular helminthes, AT type 2 immunity is active independently of infection, and promotes tissue homeostasis, AT “browning,” and systemic insulin sensitivity, protecting against obesity‐induced metabolic dysfunction and type 2 diabetes mellitus. In particular, group 2 innate lymphoid cells (ILC2s) are integral regulators of AT type 2 immunity, producing the cytokines interleukin‐5 and IL‐13, promoting eosinophils and alternatively activated macrophages, and cooperating with and promoting AT regulatory T (Treg) cells. In this review, we focus on the recent developments in our understanding of group 2 innate lymphoid cell cells and type 2 immunity in AT metabolism and homeostasis.     

Stem cell-based therapy for the treatment of Type 1 diabetes mellitus

Diabetes mellitus is the most common metabolic disorder, which occurs in two forms: Type 1 diabetes (juvenile or insulin-dependent diabetes mellitus) and Type 2 diabetes (adult or noninsulin-dependent diabetes mellitus). Type 1 diabetes mellitus is a T-cell-mediated, organ-specific autoimmune disorder, in which the body's own immune system attacks beta-cells and damages them sufficiently resulting in reduced insulin production. To overcome autoimmunity, immunosuppressive therapy, gene therapy, islet cell regeneration or encapsulation of islet cells offer dramatic treatment solutions. At present, efforts for finding ways to replace damaged insulin-secreting beta-cells by implanting new cells is an active field of research. Various therapeutic strategies are under investigation and stem cell-based therapy with the combination of other treatments offers exciting possibilities for the development of treatment for such diseases. In the current review, we focus on stem cells and their potential clinical applications and summarize the recent progress in this field.     

糖尿病并发抑郁症的研究进展

抑郁症在糖尿病人群中的发病率显著高于非糖尿病人群,是糖尿病的重要并发症之一。抑郁与下丘脑-垂体-肾上腺素轴的活动相关,可导致升糖激素增多,胰岛素分泌水平降低。近年来,糖尿病并发抑郁症的潜在机制研究愈来愈受到医学界的重视。高血糖氧化应激状态下产生的过多自由基,以及与之伴随的高分子氧化损伤可能在糖尿病诱导抑郁的发生过程中起到重要作用。同时,炎症与线粒体的功能损伤可能也参与了抑郁在糖尿病患者的发生发展过程。糖尿病引发的神经系统的改变,包括神经递质的改变,重要区域的结构变化,神经细胞凋亡的发生等,都可能是其抑郁症高发的原因。本文主要阐述糖尿病并发抑郁症的研究进展。     

Prevention of cardiovascular disease in diabetes mellitus: by stressing the CARDS study

Recently, diabetes mellitus has become a global epidemic disease. There is a study indicating that type 2 diabetes mellitus (DM) is frequently found in children and teenager. Furthermore, in some countries, it is more frequent than type 1 diabetes mellitus.1 WHO stated that in the year of 2000, there were 177 million diabetes mellitus patient in the world and it is predicted that in the year of 2030, it will be increased to 366 million.2 This is very problematical for some countries such as India, People's Republic of China and Indonesia where the prevention and treatment facilities are still inadequate. To date, Indonesia has occupied the 4th rank, with predicted number of diabetes mellitus patient about 8.4 million and this number will be increased to 21.3 million in the year of 2030. There is no data about the number of patient with metabolic syndrome (MS) and insulin resistance syndrome (IR), but it should be higher than the number of diabetic patient. As we all have known, these conditions are the high-risk condition of diabetes mellitus development.2 One of reasons concerning why prevalence and pre-diabetic condition are increased (including the increased MS) is rising obesity frequency. In the United States, over 60% of recent adult population are overweight, which is defined as "body mass index" (BMI) 25; and about 30% of them have obesity, which is defined as BMI 30%.3 If diabetes mellitus occurred, cardiovascular disease (CVD) including coronary heart disease (CHD) also may occur. It is important to prevent the diabetes mellitus as well as to prevent the complication risk of CVD in diabetic patient.     

Transplantation of cultured fetal pancreatic islet cells in the treatment of insulin-dependent diabetes mellitus

Fetal tissue grafting has been used in Russia for some 15 years for the treatment of insulin-dependent diabetes mellitus with complications. The use of cultured islet cells from the fetal human, as well as animal, pancreas has been successful even in the absence of immunosuppression. This review concerns only studies carried out in the CIS and the rest of the former USSR. It describes the treatment of complications of diabetes mellitus (retinopathy, nephropathy, polyneuropathy), the treatment of diabetes mellitus in children and pregnant women, and the preparation of patients with diabetes mellitus for surgery. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 117, N ^o 4, pp. 356–363, April, 1994     

Knowledge and diabetes self-management

This paper discusses the role of knowledge in the self-management of diabetes mellitus and addresses limitations in the measurement of knowledge in studies which have been undertaken. In addition, the findings of a recent investigation related to knowledge of diabetes in young adults with the condition are reported. The results showed high levels of knowledge and glycosylated haemoglobin values which were acceptable when length of time with diabetes was considered. However, no relationship between knowledge and level of glycaemic control was demonstrated. In the light of recent research confirming the need for tighter metabolic control, the implications of these findings in relation to future research and the education of health care professionals are considered. Although this paper relates to diabetes mellitus many of the issues raised are equally applicable to the wider forum of chronic illness management.     

Autoantibodies to GABA-ergic neurons and pancreatic beta cells in stiff-man syndrome

Stiff-man syndrome is a rare disorder of the central nervous system of unknown pathogenesis. We have previously reported the presence of autoantibodies against glutamic acid decarboxylase (GAD) in a patient with stiff-man syndrome, epilepsy, and insulin-dependent diabetes mellitus. GAD is an enzyme selectively concentrated in neurons secreting the neurotransmitter gamma-aminobutyric acid (GABA) and in pancreatic beta cells. We subsequently observed autoantibodies to GABA-ergic neurons in 20 of 33 patients with stiff-man syndrome. GAD was the principal autoantigen. In the group of patients positive for autoantibodies against GABA-ergic neurons, there was a striking association with organ-specific autoimmune diseases, primarily insulin-dependent diabetes mellitus. These findings support the hypothesis that stiff-man syndrome is an autoimmune disease and suggest that GAD is the primary autoantigen involved in stiff-man syndrome and the associated insulin-dependent diabetes mellitus. Our findings also indicate that autoantibodies directed against GABA-ergic neurons are a useful marker in the diagnosis of the disease.     

The pathogenic role of tissue-resident immune cells in psoriasis

Psoriasis is a common chronic inflammatory skin disease, the study of which might also be of considerable value to the understanding of other inflammatory and autoimmune-type diseases, such as rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis and diabetes mellitus. There is clear evidence that T cells and dendritic cells have a central role in psoriasis. Based on recent data from humans and animal models, we propose that a psoriasis lesion can be triggered and sustained by the local network of skin-resident immune cells. This concept focuses attention on local, rather than systemic, components of the immune system for rationalized therapeutic approaches of psoriasis and possibly also other chronic inflammatory diseases.     

妊娠期糖尿病发病的相关因素

妊娠期糖尿病(gestational diabetes mellitus,GDM)为妊娠前糖代谢正常或有潜在糖耐量减退,妊娠期才出现或发现糖尿病。糖尿病孕妇中80%以上为GDM,GDM发病率世界各国报道1%~14%。我国发病率1%~5%,近年有明显增长趋势。GDM患者糖代谢多数于产后能恢复正常,但将来患2型糖尿病机会增加。对母儿均有较大危害。故应引起重视,其发病相关因素有:胰岛素抵抗、胰岛素分泌缺陷、自身的免疫遗传因素、其它因素如孕妇饮食及慢性炎症等。     

骨髓间充质干细胞促进胰岛再生的作用与研究现状

背景：研究发现,骨髓间充质干细胞移植入糖尿病大鼠后能够降低其血糖。 目的：综述骨髓间充质干细胞在促进胰岛再生方面的作用与研究现状。 方法：应用计算机检索2003年7月至2011年12月PubMed数据库相关文章,检索词为“bone marrow derive mesenchymal stem cell,islet cells”,并限定文章语言种类为English。同时计算机检索2003年7月至2011年12月万方数据库相关文章,检索词为“骨髓间充质干细胞,胰岛细胞”,并限定文章语言种类为中文。最终纳入符合标准的文献25篇。 结果与结论：目前,移植胰岛治疗糖尿病已取得良好疗效,但由于胰岛来源匮乏和异种或异体来源的胰岛引起免疫排斥反应而难以使众多糖尿患者受益。骨髓间充质干细胞取材方便,容易进行体外分离、培养和纯化,且具有多向分化潜能。若将骨髓间充质干细胞诱导分化为胰岛细胞,可望解决胰岛细胞来源和免疫排斥问题。文章对骨髓间充质干细胞分化为胰岛细胞治疗糖尿病的研究进展进行综述,并指出了存在问题和今后的研究方向。     

Diagnosis and classification of autoimmune diabetes mellitus

Diabetes mellitus is increasing in prevalence worldwide. The economic costs and burden of the disease are considerable given the cardiovascular complications and co-morbidities that it may entail. Two major groups of diabetes mellitus have been defined, type 1, or immune-based, and type 2. In recent years, other subgroups have been described in-between these major groups. Correct classification of the disease is crucial in order to ascribe the most efficient preventive, diagnostic and treatment strategies for each patient. In the present review, we discuss the epidemiology, etiopathogenesis, diagnostic criteria and clinical classification of what is currently known as autoimmune diabetes. In addition, the other groups of diabetes mellitus will be regarded in relation to their pathogenesis and potential autoimmunity features.     

Microcystic adenoma of the pancreas with myoepithelial cells. A hitherto undescribed morphologic feature

A case of microcystic adenoma (glycogen-rich cystadenoma) of the exocrine pancreas in a 62-year-old white female presenting with adult-onset diabetes mellitus is reported. Clinical, histopathologic, and ultrastructural findings are discussed with particular emphasis on the presence of myoepithelial cells, a morphologic feature not seen in this tumor previously. The controversy over diabetes mellitus as a significant related factor is also discussed.     

Differentiation of Stem Cells into Insulin-Producing Cells: Current Status and Challenges

Diabetes mellitus is one of the most serious public health challenges of the twenty-first century. Allogenic islet transplantation is an efficient therapy for type 1 diabetes. However, immune rejection, side effects of immunosuppressive treatment as well as lack of sufficient donor organs limits its potential. In recent years, several promising approaches for generation of new pancreatic β cells have been developed. This review provides an overview of current status of pancreatic and extra-pancreatic stem cells differentiation into insulin-producing cells and the possible application of these cells for diabetes treatment. The PubMed database was searched for English language articles published between 2001 and 2012, using the keyword combinations: diabetes mellitus, differentiation, insulin-producing cells, stem cells.     

Flow cytometry for the analysis of T cells expressing CD69 after stimulation with glutamic acid decarboxylase

Type 1 diabetes mellitus is a T-cell mediated autoimmune disease in which the insulin-producing pancreatic beta cells are selectively destroyed. We recently found that the detection of cell-mediated immune response to glutamic acid decarboxylase (GAD) was more useful than the detection of specific autoantibodies for the diagnosis of type 1 diabetes mellitus. In this study, we established a flow cytometric analysis for the detection of activated T cells in whole venous blood, obtained from diabetic patients and normal controls after stimulation by GAD. Two millitiers of peripheral venous blood and 6 hours incubation time were used for performing the test. It was found that 33% (3/9) type 1 diabetic patients, 7.7% (1/13) type 2 diabetic patients and neither patients with fibrocalculous pancreatopathy nor normal controls had > or = 20% CD8+ T cells expressing CD69. The results suggest that flow cytometry may be a useful tool for the detection of surrogate markers of type 1 diabetes mellitus.     

肾移植后并发糖尿病的危险因素及治疗

背景：肾移植后并发糖尿病是肾移植治疗后常见的并发症之一。 目的：探讨肾移植后并发糖尿病的危险因素以及临床治疗。 方法：应用数据库文献检索的方法获取肾移植后并发糖尿病研究的文献,对符合研究标准的文献进行深入的数据分析,文章选取肾移植后并发糖尿病的危险因素进行深入分析,并总结国内外关于肾移植后并发糖尿病的治疗方法。 结果与结论：肾移植后并发糖尿病是由多种因素作用而引起的糖代谢异常,肾移植后并发糖尿病与患者年龄、体质量指数、血脂水平、免疫抑制剂方案、急性排斥发生频率、糖皮质激素累积等因素相关。在肾移植后定期检测血糖变化,可以较早的发现糖尿病的发生,通过中西医药物降低血糖和调整免疫抑制剂等方法可以有效治疗。