RESUMO
Type 1 diabetes (T1D) is caused by an inflammatory destruction of pancreatic beta-cells. Pro-inflammatory cytokines, in particular interleukin-1 (IL-1), have been suggested to be effector molecules based on the observations that pro-inflammatory cytokines cause beta-cell apoptosis in vitro and aggravate diabetes in vivo, and that inhibition of the action of these cytokines reduce diabetes incidence in animal models of type 1 diabetes and islet graft destruction. This review presents the rationale for and design of a recently launched double-blind, multicenter, randomized clinical trial that investigates the effect of interleukin-1 antagonism on beta-cell function in subjects with T1D of recent-onset.
Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Fatores Imunológicos/uso terapêutico , Células Secretoras de Insulina/efeitos dos fármacos , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Interleucina-1/antagonistas & inibidores , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Animais , Criança , Diabetes Mellitus Tipo 1/imunologia , Método Duplo-Cego , Humanos , Células Secretoras de Insulina/imunologia , Estudos Multicêntricos como Assunto/métodos , Projetos de PesquisaRESUMO
Rubella infection in utero is associated with a high risk of later development of type 1 diabetes. The mechanism is still unclear although the balance between the so-called Th1 and Th2 immune response seems to be important. Whether viral infections are involved in the pathogenesis of the common type of immune mediated type 1 diabetes is still unclear. Prospective serological investigations suggest a higher frequency of enteroviral infections in utero or in early childhood in children later developing type 1 diabetes. There is a need for confirmatory investigations of these observations especially with regard to demonstration of viral genome.
Assuntos
Diabetes Mellitus Tipo 1/virologia , Animais , Pré-Escolar , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/imunologia , Diabetes Mellitus Tipo 1/imunologia , Infecções por Enterovirus/complicações , Infecções por Enterovirus/imunologia , Feminino , Humanos , Ilhotas Pancreáticas/citologia , Ilhotas Pancreáticas/imunologia , Ilhotas Pancreáticas/virologia , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/virologia , Efeitos Tardios da Exposição Pré-Natal , Estudos Prospectivos , Fatores de Risco , Rubéola (Sarampo Alemão)/complicações , Rubéola (Sarampo Alemão)/congênito , Rubéola (Sarampo Alemão)/imunologiaRESUMO
After introduction of recombinant human insulin, immunological reactions have become rare, but symptomatic immune reactions to insulin still occur. We present four insulin-treated diabetic patients who developed hypersensitivity to insulin or additives to insulin preparations. We show that symptomatic immunological reactions to insulin have not been eliminated by the introduction of recombinant human insulin. Furthermore it demonstrates the importance of skin-biopsy-verified diagnoses and the relevance of differentiation between different types of insulin allergy.
Assuntos
Hipersensibilidade a Drogas/etiologia , Hipoglicemiantes/efeitos adversos , Insulina/efeitos adversos , Adulto , Toxidermias/etiologia , Feminino , Humanos , Hipersensibilidade Tardia/induzido quimicamente , Hipersensibilidade Imediata/induzido quimicamente , Hipoglicemiantes/imunologia , Doenças do Complexo Imune/induzido quimicamente , Insulina/imunologia , Masculino , Pessoa de Meia-Idade , Pele/patologia , Urticária/induzido quimicamente , Urticária/patologia , Vasculite/induzido quimicamenteRESUMO
The 1999 WHO classification delineates immune mediated type 1 diabetes from other types of diabetes by the presence of auto-antibodies against beta-cell constituents. The GAD65 auto-antibody test is the method of first choice because it has the highest sensitivity, specificity and positive predictive value and is the most standardized and well-characterized type 1 diabetes related auto-antibody analysis. It is recommended that demonstration of GAD auto-antibodies leads to diagnosis, classification or re-classification of diabetes patients as immune mediated type 1 diabetes.