1 型糖尿病的内型：B 淋巴细胞与早发。
Endotypes in T1D: B lymphocytes and early onset.
机构信息
Barbara Davis Center for Diabetes.
Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA.
出版信息
Curr Opin Endocrinol Diabetes Obes. 2020 Aug;27(4):225-230. doi: 10.1097/MED.0000000000000547.
PURPOSE OF REVIEW
Although type 1 diabetes (T1D) is characterized by destruction of the pancreatic beta cells by self-reactive T cells, it has become increasingly evident that B cells also play a major role in disease development, likely functioning as antigen-presenting cells. Here we review the biology of islet antigen-reactive B cells and their participation in autoimmune diabetes.
RECENT FINDINGS
Relative to late onset, individuals who develop T1D at an early age display increased accumulation of insulin-reactive B cells in islets. This B-cell signature is also associated with rapid progression of disease and responsiveness to B-cell depletion therapy. Also suggestive of B-cell participation in disease is loss of anergy in high-affinity insulin-reactive B cells. Importantly, loss of anergy is seen in patient's healthy first-degree relatives carrying certain T1D risk alleles, suggesting a role early in disease development.
SUMMARY
Recent studies indicate that islet-reactive B cells may play a pathogenic role very early in T1D development in young patients, and suggest utility of therapies that target these cells.
目的综述
尽管 1 型糖尿病（T1D）的特征是自身反应性 T 细胞破坏胰岛β细胞，但越来越明显的是，B 细胞在疾病发展中也起着主要作用，可能作为抗原呈递细胞。本文综述了胰岛抗原反应性 B 细胞的生物学及其在自身免疫性糖尿病中的参与作用。
最近的发现
与晚发型相比，在年轻时发生 T1D 的个体，其胰岛中胰岛素反应性 B 细胞的积累增加。这种 B 细胞特征也与疾病的快速进展和对 B 细胞耗竭治疗的反应性相关。高亲和力胰岛素反应性 B 细胞失能也提示 B 细胞参与疾病。重要的是，在携带某些 T1D 风险等位基因的患者健康一级亲属中也观察到失能，这表明在疾病发展的早期就有作用。
总结
最近的研究表明，在年轻患者的 T1D 发展早期，胰岛反应性 B 细胞可能发挥致病性作用，并提示针对这些细胞的治疗具有一定的应用价值。
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