TYPE 1 DIABETES MELLITUS — IMMUNE DYSREGULATION AND NEW TREATMENT STRATEGIES
Abstract
Type 1 diabetes mellitus (T1D) is a disease in which a combination of genetic, environmental, infectious and other factors leads to autoimmune damage to pancreatic B cells. The highest genetic risk for T1DM is due to human leukocyte antigen (HLA) class II haplotypes HLA-DR3-DQ2 and HLA-DR4-DQ8, as well as different sequences in the insulin gene. Chemical predisposing factors for the development of diabetes include certain substances (bisphenol, phthalates, etc.) that are part of plastic, metal cans and other materials. Among infectious agents, the leading position is occupied by the Coxsackie virus, which has several diabetogenic mechanisms and is also able to persist in the human body. The disease has a certain staging: clinical manifestations of the disease do not appear immediately, but only after multiple positive tests for autoantibodies and episodes of dysglycemia. This paper presents immunological and biochemical disorders that occur when exposed to the above factors, and examines the involvement of the innate immune response (neutrophils) in the development of the disease. In addition, an analysis of new experimental treatment methods was conducted, the goals of which were to stop and prevent the immunopathological process. Some drugs that affect various pathways of the immune response have shown good results, while others are still undergoing clinical trials. The paper examines the mechanisms of action, effectiveness, and other features of these drugs. The study of etiological and pathogenetic aspects, as well as the development of new drugs, can make a significant contribution to solving the problem of type 1 diabetes.
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