Abstract:
:Insulin-dependent diabetes mellitus is associated with a growing number of immune abnormalities. At the time of clinical onset, most patients developing the disease as children or young adults have autoantibodies reactive with islet beta cells. Current autoantibody markers for IDDM are not sufficient to predict the disease in the general population. Studies in first-degree relatives indicate the presence of a subclinical disease characterized by beta cell dysfunction, which may or may not progress to overt IDDM. Although IDDM is genetically linked to certain HLA-DQ class II molecules, it needs to be clarified whether these molecules determine the propensity to react to certain antigens, the failure to maintain tolerance, or the ability to produce disease-associated autoantibodies. Circumstantial evidence suggests that yet another gene outside the HLA complex on chromosome 6 is more important. The interaction with the environment needs to be clarified, and the etiologic role of viruses has not been substantiated. An underlying systemic autoimmune propensity may influence environmental insults and perpetuate islet beta cell destruction. Until these mechanisms are understood, clinicians should periodically check their patients with IDDM for other organ-specific as well as non--organ-specific autoimmune diseases. Our understanding of these phenomena is poor, which may explain why clinical trials with immunosuppressive agents have been of limited success. Further studies on the molecular biology of the immune response against islet beta cell-specific antigens are necessary for the development of both predictive tests and novel measures to prevent IDDM.
journal_name
Endocrinol Metab Clin North Amjournal_title
Endocrinology and metabolism clinics of North Americaauthors
Lernmark A,Bärmeier H,Dube S,Hagopian W,Karlsen A,Wassmuth Rsubject
Has Abstractpub_date
1991-09-01 00:00:00pages
589-617issue
3eissn
0889-8529issn
1558-4410journal_volume
20pub_type
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70023-2
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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journal_title:Endocrinology and metabolism clinics of North America
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2010.05.008
更新日期:2010-09-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:1999-06-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2009.01.002
更新日期:2009-06-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:2013-06-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::The immune system, through a complex interplay of highly specialized cells and a seemingly endless number of soluble mediators, works to ensure protection from the potentially harmful pathogens that we encounter in our lifetime. The development of the immune system is a compromise between the necessity to recognize fo...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(01)00016-0
更新日期:2002-06-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-12-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(01)00022-6
更新日期:2002-03-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:2002-06-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:2016-09-01 00:00:00
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journal_title:Endocrinology and metabolism clinics of North America
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journal_title:Endocrinology and metabolism clinics of North America
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更新日期:1993-12-01 00:00:00
abstract::Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitab...
journal_title:Endocrinology and metabolism clinics of North America
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journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:1990-06-01 00:00:00
abstract::Urinary stone disease is the only clinical presentation in patients with cystinuria. Two genes have been associated with type I (SLC3A1) and non-type I (SLC7A9) cystinuria and multiple mutations of these genes have been identified. The type I form is completely recessive while the non-type I form is incompletely reces...
journal_title:Endocrinology and metabolism clinics of North America
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journal_title:Endocrinology and metabolism clinics of North America
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更新日期:2019-03-01 00:00:00
abstract::Pheochromocytomas cause the most dramatic life-threatening crises in all of endocrinology. Pheochromocytoma is an explosive clinical syndrome that may be characterized by either severe hypertension associated with cerebral, cardiac, and renal complications or hypotension, or even shock and sudden death. Other emergenc...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:1993-06-01 00:00:00
abstract::The pathogenesis of atherosclerosis in human immunodeficiency virus (HIV)-infected individuals is incompletely understood and appears to be multifactorial. Proatherogenic changes in blood and tissue lipids are associated with an increased risk of cardiovascular disease among HIV-infected subjects, and these changes ma...
journal_title:Endocrinology and metabolism clinics of North America
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abstract::The familial and genetic nature of multiple endocrine neoplasia type 1 (MEN 1) syndrome was first pointed out by Wermer in 1954, who suggested that an autosomal dominant gene with high penetrance controls the trait. The clinical picture is variable, depending mainly on which glands are involved and whether the tumors ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:1994-03-01 00:00:00
abstract::This article addresses the role of insulin resistance in the pathogenesis of type 2 diabetes. The major causes of acquired insulin resistance including aging, pregnancy, lack of physical activity, and obesity are discussed briefly. The role of free fatty acids (FFAs) as a link between obesity and insulin resistance/ty...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
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更新日期:2001-12-01 00:00:00