外泌体在糖尿病治疗中的研究进展

Research progress of exosomes in the treatment of diabetes

糖尿病(DMs)是威胁人类健康的严重代谢性疾病,其发病机制尚未明确,致病原因颇多。现已有多种糖尿病治疗方案,如注射外源胰岛素、植物源性天然产物、干细胞疗法等,但均存在难以改善胰岛β细胞、生物利用度差、免疫排斥等问题,因此亟待开发更加安全有效的治疗方案。外泌体(Exosomes)作为一种细胞分泌的囊泡,含有细胞内所有重要物质,且参与细胞间信息与物质传递,随着间充质干细胞等糖尿病有效治疗方案的逐步问世,同时包含多类同类物质的外泌体在糖尿病治疗中的潜力也逐步凸显,其可以通过多种途径同时降糖的作用被报道。本文综述了近十几年外泌体在Ⅰ型糖尿病(T1DM)与Ⅱ型糖尿病(T2DM)中的治疗方案,并介绍了其分子机制与具体治疗作用,以便为促进外泌体治疗策略在临床中的落实和应用提供参考。

Diabetes melitus(DMs) is a type of serious metabolic disease threatening human health. However, the pathogenesis is still unclear, and its causes are varied. At present, there are many treatment options for DMs, such as exogenous insulin injection, plant-derived natural product therapy, stem cell therapy. However, these therapeutic regimens have problems such as difficulty in improving pancreatic β cells, poor bioavailability and immune rejection. It is urgent to develop safer and more effective treatment programs. Exosomes, as vesicles secreted by cells, contain all the important intracellular substances, and are involved in the transmission of information and substances between cells. With the advent of mesenchymal stem cells and other new and effective treatments for diabetes, the potential of exosomes containing multiple similar substances in the treatment of diabetes has gradually been highlighted, and the role of exosomes in hypoglycemia through various ways has been continuously reported. This article reviews the therapeutic regimens of exosomes in type I diabetes mellitus(T1DM) and type II diabetes mellitus(T2DM) in recent decades, and summarizes their molecular mechanisms and specific effects, so as to promote their implementations and applications in clinical practice.