肠促胰岛素在1型糖尿病中的作用和应用前景

1型糖尿病是由于胰岛β细胞选择性破坏,而引起机体内胰岛素分泌绝对缺乏的一种自身免疫性疾病。肠促胰岛素在2型糖尿病的临床治疗中已经得到证实,但在1型糖尿病的临床应用仍有待评估,胰高血糖素样肽1(GLP-1)通过促进胰岛β细胞分泌胰岛素、抑制胰腺α细胞的胰高血糖素分泌、间接延缓胃排空和降低患者食欲来降低血糖水平,并且LP-1对胰岛β细胞有一定的保护作用。运用肠促胰岛素治疗非肥胖性糖尿病小鼠的研究中证实肠促胰岛素有免疫调节、抗炎性反应及促进胰岛β细胞再生能力,因此极有可能运用肠促胰岛素延缓1型糖尿病发病、阻止病情进展恶化、部分恢复胰岛β细胞分泌胰岛素能力。

Effects of Incretin in Type 1 Diabetes Mellitus and the Application Prospect

Type 1 diabetes（T1D） results from selective loss of pancreatic islet mass through autoimmu- nity and leads to the absolute deficiency of insulin secretion. Incretin-based therapies, have demonstrated their clinical utilities in type 2 diabetes （ T2D ）, yet, their potential clinical benefits in T1D remain to be appraised. GLP-1, in addition to its insulinotropic action in alleviating hyperglycemia, possesses beneficial effects in protecting progressive impairment of pancreatic β-cell function, preservation of β-cell mass and suppression of glucagon secretion, gastric emptying and appetite. Preclinical data using incretin-based thera- pies in diabetic NOD mice demonstrated additional effects including immuno-modulation, anti-inflammation and β-cell regeneration. Thus, data accumulated hold the promise that incretin-based therapies may be effec- tive in delaying the new-onset, halting the further progression, and partially restoring the ability of islet β-cells secretion of insulin in T1 D disease.