微生物疫苗在1型糖尿病中的应用

Application of microbial vaccines in type 1 diabetes mellitus

1型糖尿病(T1DM)是由抗原特异性T淋巴细胞对β细胞靶向破坏,引起胰岛素绝对缺乏而导致的自身免疫性疾病,患者需终身进行胰岛素治疗,其发病机制尚不完全清楚,但多项数据显示感染性疾病发病率的下降伴随着过敏和自身免疫疾病发病率的上升,因而推测环境因素在T1DM的发生中起到重要作用。现已有多种细菌、寄生虫、病毒及其成分在动物模型中被证明可以预防T1DM,因此,通过微生物疫苗进行早期免疫刺激,进而诱导自身免疫耐受,有望成为预防T1DM安全有效的新方法。本文对临床和动物研究中的1型糖尿病微生物疫苗进行综述,主要从微生物的灭活疫苗、减毒活疫苗、亚单位疫苗、核酸疫苗和活载体疫苗进行概述,并讨论了各类疫苗可能的作用机制。

Type 1 diabetes mellitus(T1DM)is an autoimmune disease characterized by the destruction ofβcells and insulin absolutely deficiency upon antigen-specific T lymphocyte attack.The patients with T1DM need insulin therapy for the whole life.Although the mechanism of T1DM is still unclear now,environmental factors play a critical role in the T1DM development because the incidence of infectious diseases is opposite to that of allergies and autoimmune diseases.So far,a variety of bacteria,parasites,viruses and their composition have been proved functional in the prevention of T1DM in animal models.Therefore,microbial vaccine,if administrated early,can induce immune tolerance and prevent the destruction of pancreatic isletβcells,which is expected to be safe and effective novel approach in treating T1DM.This paper summarizes several types of T1DM microbial vaccine and their potential mechanisms including inactivated vaccine,attenuated vaccine,subunit vaccine,DNA vaccine and living-vector vaccine.