- 期刊
以貝他細胞為標靶的糖尿病治療新趨勢
New Trends in Diabetes Treatment: Targeting Beta-Cells
摘要
最近的研究顯示第1型及2型糖尿病均肇因於患者胰臟貝他細胞缺陷，因此修復或補充貝他細胞是長期解決糖尿病的方法。以貝他細胞為標靶的糖尿病治療，旨在增加糖尿病患貝他細胞的質量並促進其貝他細胞分泌胰島素的功能。在第1型糖尿病病人，避免自體免疫破壞以維持貝他細胞的方法包括自體抗原療法、抗細胞激素療法、抗T淋巴細胞療法及抗B淋巴細胞療法。再生療法則包括類昇糖素胜肽-1類似物、胰島新生相關蛋白、上皮生長因子及胃泌素。至於治療第2型糖尿病的降血糖藥物，metformin、thiazolidinediones及ATP敏感鉀離子通道開啟劑在離體可抑制貝他細胞凋亡，而類昇糖素胜肽-1類似物及二肽基肽酶在離體及糖尿病鼠，則除抑制貝他細胞凋亡外尚可促進貝他細胞增生。然而這些研究結果仍需進一步在人體印証。我們預期今後降血糖藥物的發展，除了能控制糖尿病病人的血糖外，更能遏阻糖尿病的進展。
並列摘要
Recent studies showed beta-cell deficiency underlies both type 1 and type 2 diabetes, and restoration or replacement of beta cells is therefore the long-term solution for diabetes. Diabetes treatment targeting beta cells aims to enhance beta-cell mass and insulin secretary function. In type 1 diabetes, the strategies to arrest autoimmune destruction and maintain beta cells includes antigen-specific immunomodulation, anti-cytokine therapy, anti-T cell-therapy and anti-B cell therapy. In addition, agents to stimulate beta-cell regeneration include exenatide, islet neogenesis-associated protein, epidermal growth factor and gastrin. In type 2 diabetes, glucose-lowering drugs such as metformin, thiazolidinediones and ATP-sensitive potassium channel openers inhibit beta-cell apoptosis, whilst glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors not only inhibit beta-cell apoptosis but also foster beta cell regeneration. However, these results need to be confirmed in humans. We anticipate that future antidiabetic regimens not only focus on glucose control, but also modulate the progression of diabetes.