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Insulitis in human type 1 diabetes: The quest for an elusive lesion

机译:人类1型糖尿病中的岛炎:对难以捉摸的病变的追求

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摘要

The histopathology of type 1 diabetes is defined by a decreased β-cell mass in association with insulitis, a characteristic lymphocytic infiltration limited to the islets of Langerhans and prominent in early stage disease in children. A cytotoxic T-cell mediated destruction of insulin-producing β-cells is thought to be initiated by an unknown (auto) antigen, leading to the destruction >75% of β-cell mass at clinical diagnosis. Although considered to be pathognomonic for recent onset disease, insulitis has only been described in approximately 150 cases over the past century. This review describes the quest for this elusive lesion and gives its incidence in various patient subpopulations stratified for age of onset and duration of the disease. It discusses recent new insights into the regenerative capacity of the β-cell mass in the pre-clinical stages of the disease and relates these findings to the inflammatory processes within the islet tissue.
机译:1型糖尿病的组织病理学特征是与胰岛炎相关的β细胞量减少,胰岛炎是一种特征性的淋巴细胞浸润,仅限于Langerhans胰岛,在儿童早期疾病中表现突出。人们认为细胞毒性T细胞介导的胰岛素生成β细胞的破坏是由未知(自身)抗原引发的,在临床诊断时导致> 75%的β细胞团块破坏。尽管被认为是最近发作疾病的病原体,但在过去的一个世纪中,仅在大约150例病例中描述了绝缘炎。这篇综述描述了对这种难以捉摸的病变的追求,并给出了其在各种患者亚群中的发病率,这些亚群按发病年龄和疾病持续时间分层。它讨论了对疾病前临床阶段β细胞团块再生能力的最新见解,并将这些发现与胰岛组织内的炎症过程相关联。

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