BACKGROUND Transforming growth factor-β(TGF-β)superfamily plays an important role in tumor progression and metastasis.Activin A receptor type 1C(ACVR1C)is a TGF-βtype I receptor that is involved in tumorigenesis th...BACKGROUND Transforming growth factor-β(TGF-β)superfamily plays an important role in tumor progression and metastasis.Activin A receptor type 1C(ACVR1C)is a TGF-βtype I receptor that is involved in tumorigenesis through binding to dif-ferent ligands.AIM To evaluate the correlation between single nucleotide polymorphisms(SNPs)of ACVR1C and susceptibility to esophageal squamous cell carcinoma(ESCC)in Chinese Han population.METHODS In this hospital-based cohort study,1043 ESCC patients and 1143 healthy controls were enrolled.Five SNPs(rs4664229,rs4556933,rs77886248,rs77263459,rs6734630)of ACVR1C were assessed by the ligation detection reaction method.Hardy-Weinberg equilibrium test,genetic model analysis,stratified analysis,linkage disequi-librium test,and haplotype analysis were conducted.RESULTS Participants carrying ACVR1C rs4556933 GA mutant had significantly decreased risk of ESCC,and those with rs77886248 TA mutant were related with higher risk,especially in older male smokers.In the haplotype analysis,ACVR1C Trs4664229Ars4556933Trs77886248Crs77263459Ars6734630 increased risk of ESCC,while Trs4664229Grs4556933Trs77886248Crs77263459Ars6734630 was associated with lower susceptibility to ESCC.CONCLUSION ACVR1C rs4556933 and rs77886248 SNPs were associated with the susceptibility to ESCC,which could provide a potential target for early diagnosis and treatment of ESCC in Chinese Han population.展开更多
ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a ...ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.展开更多
Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,im...Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or cytokines.Teplizumab is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target antigen.Preclinical and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of T1DM.The benefits have been apparent as early as six months to as long as seven years after therapy.It has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of age.In their recent metaanalysis published in the World Journal of Diabetes,Ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety profile.However,all the included randomized control trials have been conducted in high-income countries.High cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.展开更多
In this article,we review the study by Jin et al,which examined the role of intestinal glucagon-like peptide-1(GLP-1)in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus(T1DM).With ...In this article,we review the study by Jin et al,which examined the role of intestinal glucagon-like peptide-1(GLP-1)in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus(T1DM).With the global rise of T1DM,there is an increased burden on society and healthcare systems.Due to insulin therapy and islet dysfunction,T1DM patients are highly vulnerable to severe hypoglycemia,a leading cause of mortality.In healthy individuals,counterregulatory mechanisms restore blood glucose during hypoglycemia,but repeated episodes impair these responses.Jin et al demonstrated that overexpression of GLP-1 attenuates the sympathetic-adrenal reflex and disrupts the secretion of counterregulatory hormones such as glucagon during hypoglycemia,leading to counterregulatory dysfunction.These findings highlight the critical role of GLP-1 in the impaired counterregulatory response to hypoglycemia in T1DM patients and provide new insights into the potential application of GLP-1-related therapies in T1DM patients.展开更多
A recent nationwide cohort study reported an increased incidence and altered seasonality of type 1 diabetes mellitus(T1DM)during the coronavirus disease 2019(COVID-19)pandemic.The study found that new-onset T1DM cases...A recent nationwide cohort study reported an increased incidence and altered seasonality of type 1 diabetes mellitus(T1DM)during the coronavirus disease 2019(COVID-19)pandemic.The study found that new-onset T1DM cases were significantly higher during the pandemic than in prior years,and the typical winter peak in T1DM diagnoses was blunted.This occurred alongside markedly reduced circulation of other respiratory viruses under lockdown measures.Carmon et al noted weak positive correlations between T1DM incidence and certain viruses(e.g.,influenza and respiratory syncytial virus),suggesting that reduced exposure to common infections-and possibly severe acute respiratory syndrome coronavirus 2 infection itself-might have contributed to the rise in T1DM.To highlight key methodological limitations of that study,which may affect the interpretation of the findings.We reviewed the study design and data of Carmon et al and discussed potential biases,including ecological inference,confounding factors,delayed diagnoses,lack of COVID-19-stratified analysis,and biases in viral surveillance data,supported by recent literature.The association observed by Carmon et al is at risk of ecological fallacy due to the absence of individual infection linkage.Uncontrolled confounders(healthcare access,socioeconomic changes)and not stratifying by COVID-19 infection status limit causal inference.Pandemic-related diagnostic delays likely inflated apparent T1DM incidence,as evidenced by higher rates of diabetic ketoacidosis in new cases.Biases in virological testing data(reduced testing and non-representative sampling)complicate conclusions about“reduced”viral circulation.The pandemic’s impact on T1DM incidence is important but requires cautious interpretation.Future studies should employ individual-level analyses,adjust for confounders,distinguish true incidence increases from diagnostic delays,stratify by infection status,and use comprehensive viral exposure data to draw more robust conclusions.展开更多
This study reviews the anti-inflammatory potential of cannabidiol(CBD)in the management of type 1 diabetes(T1D).A comprehensive search was conducted across PubMed,Scopus,and ScienceDirect databases using the terms“ty...This study reviews the anti-inflammatory potential of cannabidiol(CBD)in the management of type 1 diabetes(T1D).A comprehensive search was conducted across PubMed,Scopus,and ScienceDirect databases using the terms“type 1 diabetes”,“cannabidiol”,“anti-inflammatory effect”,and“CBD”.Articles published between 2005 and 2025 were screened,and studies involving animal models that examined CBD as a therapeutic intervention for T1D and reported on its antiinflammatory effects were included.Of the 62 retrieved articles,only 6 met the predefined inclusion criteria.Although limited in number,the available studies show promising outcomes.CBD demonstrates potential as an adjuvant therapy for T1D due to its immunomodulatory and anti-inflammatory actions.Nonetheless,further research is required to establish safe and effective clinical application protocols.展开更多
BACKGROUND Type 1 diabetes mellitus(T1DM)is an autoimmune disease with a multifactorial pathogenesis.Viral infections have been proposed as contributing triggers,supported by the disease’s seasonal pattern,which typi...BACKGROUND Type 1 diabetes mellitus(T1DM)is an autoimmune disease with a multifactorial pathogenesis.Viral infections have been proposed as contributing triggers,supported by the disease’s seasonal pattern,which typically shows higher incidence in autumn and winter.The coronavirus disease 2019(COVID-19)pandemic and associated lockdowns created a unique context to examine the incidence and seasonality of T1DM during a period characterized by reduced circulation of common viral infections.AIM To investigate the incidence and seasonality of T1DM before and during COVID-19 pandemic in relation to global viral infection rates.METHODS This population-based retrospective study utilized a nationwide computerized database.Extracted data included the number of new T1DM cases over the 8 years preceding and during the COVID-19 pandemic,demographic characteristics of affected individuals,and nationwide respiratory virus polymerase chain reaction data from weekly nasal wash sample collections.RESULTS A total of 2176 patients were diagnosed with new-onset T1DM during the prepandemic period,compared to 348 cases during the pandemic.In the same periods,33727 respiratory virus-positive polymerase chain reaction results from nasal wash samples were recorded pre-pandemic,compared to 2603 during the pandemic.Additionally,363399 positive COVID-19 cases were reported during the pandemic period.Seasonality analysis revealed a higher rate of new-onset T1DM cases and a weaker seasonal pattern during the pandemic.Trend analysis showed a consistent increase in T1DM incidence prior to COVID-19,with a more variable trend observed during the pandemic.Correlation analysis between T1DM incidence and respiratory viruses demonstrated a weak correlation between T1DM incidence and a few respiratory viruses.CONCLUSION The observed increase in new-onset T1DM cases and the disruption of its typical seasonal pattern during the COVID-19 pandemic suggest a potential association between respiratory virus exposure and the development of T1DM.展开更多
In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for c...In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for clinical practice.However,we believe that the authors should also provide information on the patient's long-term prognosis.展开更多
BACKGROUND Type 1 diabetes(T1D)results from the autoimmune-mediated loss of pancreatic β-cells.Current insulin therapies offer symptomatic relief but fall short of providing a definitive cure.Islet cell transplantati...BACKGROUND Type 1 diabetes(T1D)results from the autoimmune-mediated loss of pancreatic β-cells.Current insulin therapies offer symptomatic relief but fall short of providing a definitive cure.Islet cell transplantation,while promising,faces limitations related to donor scarcity,procedural complexities,and the necessity for long-term immunosuppression.Consequently,there is an urgent need for innovative strategies aimed at β-cell regeneration.Patient-derived induced pluripotent stem cells(iPSCs),obtained from peripheral blood mononuclear cells(PBMCs)of T1D patients,hold great potential as a source of cells for therapeutic purposes.Therefore,the differentiation of T1D-iPSCs into functional pancreatic β-cells is a critical step toward effective β-cell replacement therapy.AIM To assess the potential of patient-derived T1D-β-like cells(differentiated from T1D-iPSCs reprogrammed from T1D-PBMCs)for restoring β-cell function in T1D.METHODS T1D-iPSCs were reprogrammed from T1D-PBMCs using an episomal vectorbased approach.Pluripotency was confirmed by flow cytometry(FCM),quantitative real-time polymerase chain reaction,genomic stability analysis,and teratoma formation assays.Differentiation into pancreatic β-cells was optimized using triiodothyronine(T3),vitamin C(Vc),and an adenovirus(M3C)encoding pancreatic duodenal homeobox-1,neurogenin 3(Ngn3),and MAF bZIP transcription factor A(MafA).Following characterization of β-cell features by immunofluorescence,quantitative real-time polymerase chain reaction,and flow cytometry,therapeutic efficacy was assessed through blood glucose monitoring after transplantation under the renal capsule of streptozotocin-induced diabetic mice.RESULTS T1D-iPSCs were successfully generated from T1D-PBMCs.These cells exhibited the hallmark characteristics of pluripotent stem cells,including appropriate morphology,differentiation potential,genomic integrity,and expression of pluripotency-associated genes.Differentiation yielded insulin-positive(insulin+)pancreatic β-like cells that,at the mRNA level,expressed key β-cell markers such as pancreatic duodenal homeobox-1,Ngn3,MafA,NeuroD,glucagon-like peptide-1 receptor,Nkx6.1,glucose transporter 2,and Kir6.2.Notably,the T3+Vc group displayed the lowest Ngn3 expression(1.31±0.38 vs 1.96±0.25 vs 2.51±0.24,P<0.01),while the M3C+T3+Vc group exhibited the highest MafA expression(0.49±0.11 vs 0.32±0.06 vs 0.29±0.08,P<0.05).Both in vitro and in vivo assessments confirmed the insulin secretion ability of the generated β-like cells;however,they did not demonstrate appropriate modulation of insulin release in response to variations in extracellular glucose concentrations.CONCLUSION T1D-iPSCs derived from T1D-PBMCs can be differentiated into insulin+β-like cells,albeit with functional immaturity.These cells represent a potential source of seed cells for β-cell replacement therapy in T1D.展开更多
BACKGROUND Diabetes has become a widespread metabolic disease affecting multiple organs.Among diabetic complications,cardiovascular complications are the main cause of patient morbidity and mortality.Diabetic cardiomy...BACKGROUND Diabetes has become a widespread metabolic disease affecting multiple organs.Among diabetic complications,cardiovascular complications are the main cause of patient morbidity and mortality.Diabetic cardiomyopathy is a diabetes-specific cardiomyopathy in the absence of other cardiovascular disease and occurs more frequently in type 1 diabetes(T1D)than in type 2 diabetes.Previous studies on diabetic cardiomyopathy have predominantly focused on the effects of diabetes on left ventricular(LV)dysfunction,while studies of right ventricular(RV)dysfunction have been sparse but are gaining attention.Although T1D accounts for only 5%-10%of the total diabetic population,diabetic cardiomyopathy is a major cause of morbidity and mortality in children with life-long,long-term complications.AIM To evaluate longitudinal RV and LV functional changes in female transgenic OVE26,T1D mice and wild-type FVB mice over a 30-week period.METHODS RV and LV structure and function were evaluated by transthoracic echocardiography.RV systolic pressure was measured by a transducer-tipped pressure catheter.Sirius-red staining was used to quantify collagen and fibrosis,wheat germ agglutinin staining was utilized to measure cardiomyocyte size,and quantitative real-time polymerase chain reaction and Western blotting were used to quantify miRNA expression and protein abundance,respectively.RESULTS RV systolic function,measured by tricuspid valve annular plane systolic excursion and RV systolic velocity,was similar between control and T1D mice,but LV systolic function decreased in T1D mice at 30 weeks of age.RV diastolic dysfunction in T1D mice significantly increased by 18 weeks and progressed until 30 weeks,while LV diastolic dysfunction trended towards abnormal at 12 weeks,significantly increased by 18 weeks,and continued to progress by 30 weeks.Furthermore,RV diastolic dysfunction was accompanied by RV cardiac fibrosis and hypertrophy in T1D mice,occurring later than that in the LV.Pulmonary arterial hypertension developed in T1D mice,evidenced by increased pulmonary acceleration time to pulmonary ejection time ratio and increased RV peak systolic pressure at 30 weeks.These results suggest the development of early LV diastolic dysfunction followed by LV systolic dysfunction and RV diastolic dysfunction at 30 weeks in T1D mice.CONCLUSION RV diastolic dysfunction develops later than LV dysfunction in OVE26 T1D mice.Mild pulmonary arterial hypertension appear at later stages of T1D and could contribute to RV systolic impairment and remodeling.展开更多
An article recently published in the World Journal of Diabetes,provides valuable insights into using immune biomarkers to identify renal damage in pediatric patients with newly diagnosed type 1 diabetes(T1D).Although ...An article recently published in the World Journal of Diabetes,provides valuable insights into using immune biomarkers to identify renal damage in pediatric patients with newly diagnosed type 1 diabetes(T1D).Although these findings are promising,clinical translation of these immune markers into routine diagnostics and preventive care remains challenging.In this letter,we propose building on the authors’work by exploring the integration of immune biomarkers into a more comprehensive dynamic risk stratification model for early renal injury.Com-bining immune system indicators with metabolic and genetic factors could enhance the predictive accuracy and support more personalized interventions.Longitudinal studies are needed to evaluate temporal changes in immune biomarkers and their association with long-term renal outcomes in children with T1Ds.Immunomodulatory therapies targeting early immune dysfunction can prevent or slow the progression of diabetic nephropathy.By incorporating these aspects,we hope to translate immune biomarkers from research into practical clinical tools,ultimately improving patient outcomes and reducing the burden of kidney-related complications in pediatric diabetes.展开更多
Type 1 diabetes mellitus(T1DM)is an autoimmune condition whose prevalence is prominent in children and adolescents,resulting in insulin deficiency with a potential for long-term complications induced by glucotoxicity....Type 1 diabetes mellitus(T1DM)is an autoimmune condition whose prevalence is prominent in children and adolescents,resulting in insulin deficiency with a potential for long-term complications induced by glucotoxicity.As an autoimmune disease where the body's immune system attack insulin-producing beta cells in the pancreas,leading up to complete or near-complete inability to control the blood glucose levels independently.The lack of glycemic control calls for lifelong exogenous insulin administration in conjunction with careful monitoring to control blood sugar levels and prevent acute and chronic health issues complications.Regular physical activity,notably resistance exercise(RE),may be beneficial in the glycemic management of this population,enhancement of muscle strength,and general health for the growing,development and maturation in children.The evidence depicting its benefits and safeguard for RE in pediatric T1DM patients remains underexamined.This mini-review seeks to synthesize qualitatively the current evidence on RE regarding its global effects on the T1DM in children.A search for peer-reviewed papers is carried out through primary databases,centering on publications that examined the physiological,metabolic,and psychosocial consequences of RE in children with T1DM.Emerging evidence indicates that RE is one potential method of safe and efficacious intervention to improve glycemic management,physical capacity,and quality of life.However,there is still some reluctance to this type of training in the pediatric population.The available research has not only refuted the belief that strength training was contraindicated in the pediatric population but also recommends its systematic practice to enjoy its benefits on the three spheres of health.Nevertheless,methodological differences and small population studies pose challenges to drawing firm conclusions.The review underscores other areas,including the need for standardizing protocols for including patients such as follow-ups and greater considerations for psychosocial effects of RE in this population.This minireview underlines the importance of RE in a global approach to pediatric diabetes care by providing practical insight for both clinicians and researchers.展开更多
This letter comments on a study by Jin et al,published recently in the World Journal of Diabetes.Hypoglycemia is a significant complication of diabetes,with primary defense mechanisms involving the stimulation of gluc...This letter comments on a study by Jin et al,published recently in the World Journal of Diabetes.Hypoglycemia is a significant complication of diabetes,with primary defense mechanisms involving the stimulation of glucagon secretion inα-cells and the inhibition of insulin secretion in pancreaticβ-cells,which are often compromised in type 1 diabetes mellitus(T1DM)and advanced type 2 diabetes mellitus.Recurrent hypoglycemia predisposes the development of impaired hypoglycemia awareness,a condition underpinned by complex pathophysiological processes,encompassing central nervous system adaptations and several hormonal interactions,including a potential role for glucagon-like peptide-1(GLP-1)in paracrine and endocrine vias.Experimental evidence indicates that GLP-1 may impair hypoglycemic counterregulation by disrupting the sympathoadrenal system and promoting somatostatin release in pancreaticδ-cells,which inhibits glucagon secretion from neighboringα-cells.However,current trials evaluating GLP-1 receptor agonists(GLP-1 RAs)in T1DM patients have shown promising benefits in reducing insulin requirements and body weight,without increasing the risk of hypoglycemia.Further research is essential to elucidate the specific roles of GLP-1 and GLP-1 RAs in modulating glucagon secretion and the sympathetic-adrenal reflex,and their impact on hypoglycemia unawareness in T1DM patients.展开更多
Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosom...Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosome 11q13.As main etiology of MEN1 is genetic mutations,clinical symptoms may vary.In this editorial,we comment on the article by Yuan et al.This article describes a case of(MEN1)characterized by low incidence and diagnostic complexity.MEN1 co-mmonly presents as parathyroid,pancreatic,and pituitary tumors.Diagnosis requires a combination of serologic tests,magnetic resonance imaging,computed tomography,endoscopic ultrasonography,immunologic and pathology.The diagnosis is unique depending on the site of disease.Surgical resection is the treatment of choice for MEN1.The prognosis depends on the site of origin,but early detection and intervention is the most effective.展开更多
This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao ...This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao et al,this article aims to highlight the importance of early detection and intervention.This study compre-hensively analyzes various SIIs,examining their correlation with renal compli-cations in newly diagnosed type 1 diabetic children.The findings reveal a sig-nificant association between immune system dysregulation and the onset of renal damage,suggesting that certain immune indicators can be early markers for predicting renal complications.This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care.It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes.Additionally,it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.展开更多
BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recom...BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients.展开更多
Lin et al’s investigation on the association of activin A receptor type 1C(ACVR1C)(transforming growth factor beta type I receptor)single nucleotide poly-morphisms(SNPs)with esophageal squamous cell carcinoma(ESCC)ri...Lin et al’s investigation on the association of activin A receptor type 1C(ACVR1C)(transforming growth factor beta type I receptor)single nucleotide poly-morphisms(SNPs)with esophageal squamous cell carcinoma(ESCC)risk in the Chinese population is a scientific approach.This study explores the susceptibility of ACVR1C polymorphism towards ESCC in the Chinese population,highlighting the polymorphism’s potentiality as an early diagnostic and therapeutic target.The author assessed about a thousand ESCC Chinese patients’samples for ACVR1C SNPs in a hospital-based cohort study using the ligation detection reaction method.Further,the hypothesis was tested using appropriate statistical genetic models and stratified analysis.ACVR1C SNPs can help assess ESCC susceptibility stratification and provide valuable information for individual diagnosis and treatment of ESCC patients.In order to account for confounding variables,find genuine SNP-disease relationships,boost statistical power,and make biological interpretation easier,it is imperative that genetic association studies of ESCC incorporate pertinent clinical aspects.展开更多
BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients wi...BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients with type 1 diabetes(T1D).The glycemia risk index(GRI),a composite metric derived from continuous glucose monitoring(CGM),has emerged as a potential solution by systematically in-tegrating both hypoglycemia and hyperglycemia risks into a single interpretable score.The GRI exhibited linear correlations with HbA1c(r=0.53),time in range(r=-0.90),time above range(r=0.63),time below range(TBR)(r=0.37),and co-efficient of variation(CV)(r=0.71).It correlated strongly with TBR and CV than HbA1c.The association between HbA1c levels and GRI was influenced by TBR and CV.At a given HbA1c,each 1%increase in TBR or CV raised GRI by 1.87[95%confidence interval(CI):1.72-2.01]and 1.94(95%CI:1.80-2.10),respectively(P<0.001).Clustering of the CGM data identified four subgroups:Moderate-risk glycemic fluctuations,high-risk hypoglycemia,optimal glycemic control,and high-risk hyperglycemia.The GRI and its components for hypoglycemia and hyperglycemia could distinguish between these subgroups.CONCLUSION The GRI offers a comprehensive view of glycemic control in T1D.Combining HbA1c with the GRI enables accurate assessment for managing glycemic control in patients with T1D.展开更多
Recent advances in understanding type 1 diabetes(T1D)highlight the complexity of managing hypoglycemia,a frequent and perilous complication of diabetes therapy.This letter delves into a novel study by Jin et al,which ...Recent advances in understanding type 1 diabetes(T1D)highlight the complexity of managing hypoglycemia,a frequent and perilous complication of diabetes therapy.This letter delves into a novel study by Jin et al,which elucidates the role of intestinal glucagon-like peptide-1(GLP-1)in the counterregulatory response to hypoglycemia in T1D models.The study employed immunofluorescence,Western blotting,and enzyme-linked immunosorbent assay to track changes in GLP-1 and its receptor expression in diabetic mice subjected to recurrent hypoglycemic episodes.Findings indicate a significant increase in intestinal GLP-1 and GLP-1 receptor expression,correlating with diminished adrenal and glucagon responses,crucial for glucose stabilization during hypoglycemic events.This letter aims to explore the implications of these findings for future therapeutic strategies and the broader understanding of T1D management.展开更多
Feline herpesvirus type 1(FHV-1)is a common and highly contagious pathogen in domestic cats that causes upper respiratory tract infections and ocular diseases.Accurate and rapid diagnosis of FHV-1 infections is essent...Feline herpesvirus type 1(FHV-1)is a common and highly contagious pathogen in domestic cats that causes upper respiratory tract infections and ocular diseases.Accurate and rapid diagnosis of FHV-1 infections is essential for effective disease management and control.In this study,we developed an immunochromatographic lateral flow(ICLF)assay for the rapid and accurate detection of FHV-1-specific antibodies.The assay was founded upon the successful expression and purification of a 26 kDa recombinant glycoprotein B-glycoprotein D(gB-gD)fusion protein,which served as the primary antigen for the test.Rigorous testing for specificity and cross-reactivity confirmed the strip’s ability to exclusively detect FHV-1 antibodies,even in the presence of a variety of other feline viruses.The assay demonstrated excellent precision,reproducibility across dilutions,and long-term stability,retaining efficacy for 24 months during storage.Furthermore,clinical sample analysis revealed exceptional sensitivity(97%)and specificity(100%).In conclusion,the ICLF strip developed in this study represents a reliable,highly specific,and stable diagnostic tool for the rapid detection and management of FHV-1 infections in cats.展开更多
基金Supported by The National Natural Science Foundation of China,No.82350127 and No.82241013the Shanghai Natural Science Foundation,No.20ZR1411600+2 种基金the Shanghai Shenkang Hospital Development Center,No.SHDC2020CR4039the Bethune Ethicon Excellent Surgery Foundation,No.CESS2021TC04Xuhui District Medical Research Project of Shanghai,No.SHXH201805.
文摘BACKGROUND Transforming growth factor-β(TGF-β)superfamily plays an important role in tumor progression and metastasis.Activin A receptor type 1C(ACVR1C)is a TGF-βtype I receptor that is involved in tumorigenesis through binding to dif-ferent ligands.AIM To evaluate the correlation between single nucleotide polymorphisms(SNPs)of ACVR1C and susceptibility to esophageal squamous cell carcinoma(ESCC)in Chinese Han population.METHODS In this hospital-based cohort study,1043 ESCC patients and 1143 healthy controls were enrolled.Five SNPs(rs4664229,rs4556933,rs77886248,rs77263459,rs6734630)of ACVR1C were assessed by the ligation detection reaction method.Hardy-Weinberg equilibrium test,genetic model analysis,stratified analysis,linkage disequi-librium test,and haplotype analysis were conducted.RESULTS Participants carrying ACVR1C rs4556933 GA mutant had significantly decreased risk of ESCC,and those with rs77886248 TA mutant were related with higher risk,especially in older male smokers.In the haplotype analysis,ACVR1C Trs4664229Ars4556933Trs77886248Crs77263459Ars6734630 increased risk of ESCC,while Trs4664229Grs4556933Trs77886248Crs77263459Ars6734630 was associated with lower susceptibility to ESCC.CONCLUSION ACVR1C rs4556933 and rs77886248 SNPs were associated with the susceptibility to ESCC,which could provide a potential target for early diagnosis and treatment of ESCC in Chinese Han population.
基金Supported by the National Key R D Program of China,No.2022YFC2010102Natural Science Foundation of Hunan Province,No.2021JC0003+1 种基金National Natural Science Foundation of China,No.82070812the Sinocare Diabetes Foundation,No.LYF2022039.
文摘ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.
文摘Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or cytokines.Teplizumab is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target antigen.Preclinical and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of T1DM.The benefits have been apparent as early as six months to as long as seven years after therapy.It has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of age.In their recent metaanalysis published in the World Journal of Diabetes,Ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety profile.However,all the included randomized control trials have been conducted in high-income countries.High cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.
基金Supported by the National Natural Science Foundation of China,No.82400966Guangdong Basic and Applied Basic Research Foundation,No.2021A1515111025Science and Technology Projects in Guangzhou,No.2024A04J5170.
文摘In this article,we review the study by Jin et al,which examined the role of intestinal glucagon-like peptide-1(GLP-1)in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus(T1DM).With the global rise of T1DM,there is an increased burden on society and healthcare systems.Due to insulin therapy and islet dysfunction,T1DM patients are highly vulnerable to severe hypoglycemia,a leading cause of mortality.In healthy individuals,counterregulatory mechanisms restore blood glucose during hypoglycemia,but repeated episodes impair these responses.Jin et al demonstrated that overexpression of GLP-1 attenuates the sympathetic-adrenal reflex and disrupts the secretion of counterregulatory hormones such as glucagon during hypoglycemia,leading to counterregulatory dysfunction.These findings highlight the critical role of GLP-1 in the impaired counterregulatory response to hypoglycemia in T1DM patients and provide new insights into the potential application of GLP-1-related therapies in T1DM patients.
文摘A recent nationwide cohort study reported an increased incidence and altered seasonality of type 1 diabetes mellitus(T1DM)during the coronavirus disease 2019(COVID-19)pandemic.The study found that new-onset T1DM cases were significantly higher during the pandemic than in prior years,and the typical winter peak in T1DM diagnoses was blunted.This occurred alongside markedly reduced circulation of other respiratory viruses under lockdown measures.Carmon et al noted weak positive correlations between T1DM incidence and certain viruses(e.g.,influenza and respiratory syncytial virus),suggesting that reduced exposure to common infections-and possibly severe acute respiratory syndrome coronavirus 2 infection itself-might have contributed to the rise in T1DM.To highlight key methodological limitations of that study,which may affect the interpretation of the findings.We reviewed the study design and data of Carmon et al and discussed potential biases,including ecological inference,confounding factors,delayed diagnoses,lack of COVID-19-stratified analysis,and biases in viral surveillance data,supported by recent literature.The association observed by Carmon et al is at risk of ecological fallacy due to the absence of individual infection linkage.Uncontrolled confounders(healthcare access,socioeconomic changes)and not stratifying by COVID-19 infection status limit causal inference.Pandemic-related diagnostic delays likely inflated apparent T1DM incidence,as evidenced by higher rates of diabetic ketoacidosis in new cases.Biases in virological testing data(reduced testing and non-representative sampling)complicate conclusions about“reduced”viral circulation.The pandemic’s impact on T1DM incidence is important but requires cautious interpretation.Future studies should employ individual-level analyses,adjust for confounders,distinguish true incidence increases from diagnostic delays,stratify by infection status,and use comprehensive viral exposure data to draw more robust conclusions.
文摘This study reviews the anti-inflammatory potential of cannabidiol(CBD)in the management of type 1 diabetes(T1D).A comprehensive search was conducted across PubMed,Scopus,and ScienceDirect databases using the terms“type 1 diabetes”,“cannabidiol”,“anti-inflammatory effect”,and“CBD”.Articles published between 2005 and 2025 were screened,and studies involving animal models that examined CBD as a therapeutic intervention for T1D and reported on its antiinflammatory effects were included.Of the 62 retrieved articles,only 6 met the predefined inclusion criteria.Although limited in number,the available studies show promising outcomes.CBD demonstrates potential as an adjuvant therapy for T1D due to its immunomodulatory and anti-inflammatory actions.Nonetheless,further research is required to establish safe and effective clinical application protocols.
文摘BACKGROUND Type 1 diabetes mellitus(T1DM)is an autoimmune disease with a multifactorial pathogenesis.Viral infections have been proposed as contributing triggers,supported by the disease’s seasonal pattern,which typically shows higher incidence in autumn and winter.The coronavirus disease 2019(COVID-19)pandemic and associated lockdowns created a unique context to examine the incidence and seasonality of T1DM during a period characterized by reduced circulation of common viral infections.AIM To investigate the incidence and seasonality of T1DM before and during COVID-19 pandemic in relation to global viral infection rates.METHODS This population-based retrospective study utilized a nationwide computerized database.Extracted data included the number of new T1DM cases over the 8 years preceding and during the COVID-19 pandemic,demographic characteristics of affected individuals,and nationwide respiratory virus polymerase chain reaction data from weekly nasal wash sample collections.RESULTS A total of 2176 patients were diagnosed with new-onset T1DM during the prepandemic period,compared to 348 cases during the pandemic.In the same periods,33727 respiratory virus-positive polymerase chain reaction results from nasal wash samples were recorded pre-pandemic,compared to 2603 during the pandemic.Additionally,363399 positive COVID-19 cases were reported during the pandemic period.Seasonality analysis revealed a higher rate of new-onset T1DM cases and a weaker seasonal pattern during the pandemic.Trend analysis showed a consistent increase in T1DM incidence prior to COVID-19,with a more variable trend observed during the pandemic.Correlation analysis between T1DM incidence and respiratory viruses demonstrated a weak correlation between T1DM incidence and a few respiratory viruses.CONCLUSION The observed increase in new-onset T1DM cases and the disruption of its typical seasonal pattern during the COVID-19 pandemic suggest a potential association between respiratory virus exposure and the development of T1DM.
基金Supported by National Natural Science Foundation of China,No.821706751·3·5 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC21011.
文摘In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for clinical practice.However,we believe that the authors should also provide information on the patient's long-term prognosis.
基金Supported by the Nonprofit Research Institutes Foundation of Fujian Province,China,No.2020R1011003 and No.2022R1012001the Talents Training Project for the Key Young Scholars of Fujian Provincial Health Commission,China,No.2021GGA056.
文摘BACKGROUND Type 1 diabetes(T1D)results from the autoimmune-mediated loss of pancreatic β-cells.Current insulin therapies offer symptomatic relief but fall short of providing a definitive cure.Islet cell transplantation,while promising,faces limitations related to donor scarcity,procedural complexities,and the necessity for long-term immunosuppression.Consequently,there is an urgent need for innovative strategies aimed at β-cell regeneration.Patient-derived induced pluripotent stem cells(iPSCs),obtained from peripheral blood mononuclear cells(PBMCs)of T1D patients,hold great potential as a source of cells for therapeutic purposes.Therefore,the differentiation of T1D-iPSCs into functional pancreatic β-cells is a critical step toward effective β-cell replacement therapy.AIM To assess the potential of patient-derived T1D-β-like cells(differentiated from T1D-iPSCs reprogrammed from T1D-PBMCs)for restoring β-cell function in T1D.METHODS T1D-iPSCs were reprogrammed from T1D-PBMCs using an episomal vectorbased approach.Pluripotency was confirmed by flow cytometry(FCM),quantitative real-time polymerase chain reaction,genomic stability analysis,and teratoma formation assays.Differentiation into pancreatic β-cells was optimized using triiodothyronine(T3),vitamin C(Vc),and an adenovirus(M3C)encoding pancreatic duodenal homeobox-1,neurogenin 3(Ngn3),and MAF bZIP transcription factor A(MafA).Following characterization of β-cell features by immunofluorescence,quantitative real-time polymerase chain reaction,and flow cytometry,therapeutic efficacy was assessed through blood glucose monitoring after transplantation under the renal capsule of streptozotocin-induced diabetic mice.RESULTS T1D-iPSCs were successfully generated from T1D-PBMCs.These cells exhibited the hallmark characteristics of pluripotent stem cells,including appropriate morphology,differentiation potential,genomic integrity,and expression of pluripotency-associated genes.Differentiation yielded insulin-positive(insulin+)pancreatic β-like cells that,at the mRNA level,expressed key β-cell markers such as pancreatic duodenal homeobox-1,Ngn3,MafA,NeuroD,glucagon-like peptide-1 receptor,Nkx6.1,glucose transporter 2,and Kir6.2.Notably,the T3+Vc group displayed the lowest Ngn3 expression(1.31±0.38 vs 1.96±0.25 vs 2.51±0.24,P<0.01),while the M3C+T3+Vc group exhibited the highest MafA expression(0.49±0.11 vs 0.32±0.06 vs 0.29±0.08,P<0.05).Both in vitro and in vivo assessments confirmed the insulin secretion ability of the generated β-like cells;however,they did not demonstrate appropriate modulation of insulin release in response to variations in extracellular glucose concentrations.CONCLUSION T1D-iPSCs derived from T1D-PBMCs can be differentiated into insulin+β-like cells,albeit with functional immaturity.These cells represent a potential source of seed cells for β-cell replacement therapy in T1D.
基金Supported by the University of Louisville-China Pediatric Research Exchange Program(Cai L,Tan Y,Huang J,and Keller B,no salary support)University of Louisville Executive Vice President for Research and Innovation Internal Grant(Huang J and Cai L)University of Louisville School of Medicine Basic Grant(Huang J and Cai L).
文摘BACKGROUND Diabetes has become a widespread metabolic disease affecting multiple organs.Among diabetic complications,cardiovascular complications are the main cause of patient morbidity and mortality.Diabetic cardiomyopathy is a diabetes-specific cardiomyopathy in the absence of other cardiovascular disease and occurs more frequently in type 1 diabetes(T1D)than in type 2 diabetes.Previous studies on diabetic cardiomyopathy have predominantly focused on the effects of diabetes on left ventricular(LV)dysfunction,while studies of right ventricular(RV)dysfunction have been sparse but are gaining attention.Although T1D accounts for only 5%-10%of the total diabetic population,diabetic cardiomyopathy is a major cause of morbidity and mortality in children with life-long,long-term complications.AIM To evaluate longitudinal RV and LV functional changes in female transgenic OVE26,T1D mice and wild-type FVB mice over a 30-week period.METHODS RV and LV structure and function were evaluated by transthoracic echocardiography.RV systolic pressure was measured by a transducer-tipped pressure catheter.Sirius-red staining was used to quantify collagen and fibrosis,wheat germ agglutinin staining was utilized to measure cardiomyocyte size,and quantitative real-time polymerase chain reaction and Western blotting were used to quantify miRNA expression and protein abundance,respectively.RESULTS RV systolic function,measured by tricuspid valve annular plane systolic excursion and RV systolic velocity,was similar between control and T1D mice,but LV systolic function decreased in T1D mice at 30 weeks of age.RV diastolic dysfunction in T1D mice significantly increased by 18 weeks and progressed until 30 weeks,while LV diastolic dysfunction trended towards abnormal at 12 weeks,significantly increased by 18 weeks,and continued to progress by 30 weeks.Furthermore,RV diastolic dysfunction was accompanied by RV cardiac fibrosis and hypertrophy in T1D mice,occurring later than that in the LV.Pulmonary arterial hypertension developed in T1D mice,evidenced by increased pulmonary acceleration time to pulmonary ejection time ratio and increased RV peak systolic pressure at 30 weeks.These results suggest the development of early LV diastolic dysfunction followed by LV systolic dysfunction and RV diastolic dysfunction at 30 weeks in T1D mice.CONCLUSION RV diastolic dysfunction develops later than LV dysfunction in OVE26 T1D mice.Mild pulmonary arterial hypertension appear at later stages of T1D and could contribute to RV systolic impairment and remodeling.
文摘An article recently published in the World Journal of Diabetes,provides valuable insights into using immune biomarkers to identify renal damage in pediatric patients with newly diagnosed type 1 diabetes(T1D).Although these findings are promising,clinical translation of these immune markers into routine diagnostics and preventive care remains challenging.In this letter,we propose building on the authors’work by exploring the integration of immune biomarkers into a more comprehensive dynamic risk stratification model for early renal injury.Com-bining immune system indicators with metabolic and genetic factors could enhance the predictive accuracy and support more personalized interventions.Longitudinal studies are needed to evaluate temporal changes in immune biomarkers and their association with long-term renal outcomes in children with T1Ds.Immunomodulatory therapies targeting early immune dysfunction can prevent or slow the progression of diabetic nephropathy.By incorporating these aspects,we hope to translate immune biomarkers from research into practical clinical tools,ultimately improving patient outcomes and reducing the burden of kidney-related complications in pediatric diabetes.
文摘Type 1 diabetes mellitus(T1DM)is an autoimmune condition whose prevalence is prominent in children and adolescents,resulting in insulin deficiency with a potential for long-term complications induced by glucotoxicity.As an autoimmune disease where the body's immune system attack insulin-producing beta cells in the pancreas,leading up to complete or near-complete inability to control the blood glucose levels independently.The lack of glycemic control calls for lifelong exogenous insulin administration in conjunction with careful monitoring to control blood sugar levels and prevent acute and chronic health issues complications.Regular physical activity,notably resistance exercise(RE),may be beneficial in the glycemic management of this population,enhancement of muscle strength,and general health for the growing,development and maturation in children.The evidence depicting its benefits and safeguard for RE in pediatric T1DM patients remains underexamined.This mini-review seeks to synthesize qualitatively the current evidence on RE regarding its global effects on the T1DM in children.A search for peer-reviewed papers is carried out through primary databases,centering on publications that examined the physiological,metabolic,and psychosocial consequences of RE in children with T1DM.Emerging evidence indicates that RE is one potential method of safe and efficacious intervention to improve glycemic management,physical capacity,and quality of life.However,there is still some reluctance to this type of training in the pediatric population.The available research has not only refuted the belief that strength training was contraindicated in the pediatric population but also recommends its systematic practice to enjoy its benefits on the three spheres of health.Nevertheless,methodological differences and small population studies pose challenges to drawing firm conclusions.The review underscores other areas,including the need for standardizing protocols for including patients such as follow-ups and greater considerations for psychosocial effects of RE in this population.This minireview underlines the importance of RE in a global approach to pediatric diabetes care by providing practical insight for both clinicians and researchers.
基金Industrial Technological Initiation Scholarship of National Council for Scientific and Technological Development,CNPq,No.0932204294929829CNPq Research Productivity Fellow,No.4357511882624145.
文摘This letter comments on a study by Jin et al,published recently in the World Journal of Diabetes.Hypoglycemia is a significant complication of diabetes,with primary defense mechanisms involving the stimulation of glucagon secretion inα-cells and the inhibition of insulin secretion in pancreaticβ-cells,which are often compromised in type 1 diabetes mellitus(T1DM)and advanced type 2 diabetes mellitus.Recurrent hypoglycemia predisposes the development of impaired hypoglycemia awareness,a condition underpinned by complex pathophysiological processes,encompassing central nervous system adaptations and several hormonal interactions,including a potential role for glucagon-like peptide-1(GLP-1)in paracrine and endocrine vias.Experimental evidence indicates that GLP-1 may impair hypoglycemic counterregulation by disrupting the sympathoadrenal system and promoting somatostatin release in pancreaticδ-cells,which inhibits glucagon secretion from neighboringα-cells.However,current trials evaluating GLP-1 receptor agonists(GLP-1 RAs)in T1DM patients have shown promising benefits in reducing insulin requirements and body weight,without increasing the risk of hypoglycemia.Further research is essential to elucidate the specific roles of GLP-1 and GLP-1 RAs in modulating glucagon secretion and the sympathetic-adrenal reflex,and their impact on hypoglycemia unawareness in T1DM patients.
文摘Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosome 11q13.As main etiology of MEN1 is genetic mutations,clinical symptoms may vary.In this editorial,we comment on the article by Yuan et al.This article describes a case of(MEN1)characterized by low incidence and diagnostic complexity.MEN1 co-mmonly presents as parathyroid,pancreatic,and pituitary tumors.Diagnosis requires a combination of serologic tests,magnetic resonance imaging,computed tomography,endoscopic ultrasonography,immunologic and pathology.The diagnosis is unique depending on the site of disease.Surgical resection is the treatment of choice for MEN1.The prognosis depends on the site of origin,but early detection and intervention is the most effective.
文摘This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao et al,this article aims to highlight the importance of early detection and intervention.This study compre-hensively analyzes various SIIs,examining their correlation with renal compli-cations in newly diagnosed type 1 diabetic children.The findings reveal a sig-nificant association between immune system dysregulation and the onset of renal damage,suggesting that certain immune indicators can be early markers for predicting renal complications.This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care.It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes.Additionally,it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.
基金Supported by the National Natural Science Foundation of China,No.82471804.
文摘BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients.
文摘Lin et al’s investigation on the association of activin A receptor type 1C(ACVR1C)(transforming growth factor beta type I receptor)single nucleotide poly-morphisms(SNPs)with esophageal squamous cell carcinoma(ESCC)risk in the Chinese population is a scientific approach.This study explores the susceptibility of ACVR1C polymorphism towards ESCC in the Chinese population,highlighting the polymorphism’s potentiality as an early diagnostic and therapeutic target.The author assessed about a thousand ESCC Chinese patients’samples for ACVR1C SNPs in a hospital-based cohort study using the ligation detection reaction method.Further,the hypothesis was tested using appropriate statistical genetic models and stratified analysis.ACVR1C SNPs can help assess ESCC susceptibility stratification and provide valuable information for individual diagnosis and treatment of ESCC patients.In order to account for confounding variables,find genuine SNP-disease relationships,boost statistical power,and make biological interpretation easier,it is imperative that genetic association studies of ESCC incorporate pertinent clinical aspects.
基金Supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project,No.2023ZD0508201the National Key R and D Program of China,No.2022YFC2010100+3 种基金the National Natural Science Foundation of China,No.82070812the Natural Science Foundation of Hunan Province,No.2024JJ9049,No.2023JJ30762 and No.2021JC0003Sinocare Diabetes Foundation,No.2020SD08the National Clinical Research Center for Metabolic Diseases Clinical Diagnosis and Treatment Capacity Enhancement Program,No.2023ZLNL003.
文摘BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients with type 1 diabetes(T1D).The glycemia risk index(GRI),a composite metric derived from continuous glucose monitoring(CGM),has emerged as a potential solution by systematically in-tegrating both hypoglycemia and hyperglycemia risks into a single interpretable score.The GRI exhibited linear correlations with HbA1c(r=0.53),time in range(r=-0.90),time above range(r=0.63),time below range(TBR)(r=0.37),and co-efficient of variation(CV)(r=0.71).It correlated strongly with TBR and CV than HbA1c.The association between HbA1c levels and GRI was influenced by TBR and CV.At a given HbA1c,each 1%increase in TBR or CV raised GRI by 1.87[95%confidence interval(CI):1.72-2.01]and 1.94(95%CI:1.80-2.10),respectively(P<0.001).Clustering of the CGM data identified four subgroups:Moderate-risk glycemic fluctuations,high-risk hypoglycemia,optimal glycemic control,and high-risk hyperglycemia.The GRI and its components for hypoglycemia and hyperglycemia could distinguish between these subgroups.CONCLUSION The GRI offers a comprehensive view of glycemic control in T1D.Combining HbA1c with the GRI enables accurate assessment for managing glycemic control in patients with T1D.
文摘Recent advances in understanding type 1 diabetes(T1D)highlight the complexity of managing hypoglycemia,a frequent and perilous complication of diabetes therapy.This letter delves into a novel study by Jin et al,which elucidates the role of intestinal glucagon-like peptide-1(GLP-1)in the counterregulatory response to hypoglycemia in T1D models.The study employed immunofluorescence,Western blotting,and enzyme-linked immunosorbent assay to track changes in GLP-1 and its receptor expression in diabetic mice subjected to recurrent hypoglycemic episodes.Findings indicate a significant increase in intestinal GLP-1 and GLP-1 receptor expression,correlating with diminished adrenal and glucagon responses,crucial for glucose stabilization during hypoglycemic events.This letter aims to explore the implications of these findings for future therapeutic strategies and the broader understanding of T1D management.
基金supported by the Fundamental Research Program of Shanxi Province (202403021221077)the Central Funds Guiding the Local Science and Technology Development in Shanxi Province (YDZJSX2021 A034)+3 种基金the Project of Scientific Research for Excellent Doctors,Shanxi Province,China(SXBYKY2021047)the Research Fund (Clinical Diagnosis and Treatment of Pet) for Young College Teachers in Ruipeng Commonwealth Foundation (RPJJ2020021)the Project of Science and Technology Innovation Fund of Shanxi Agricultural University (2021BQ06)the Inner Mongolia Autonomous Region First Class Discipline Research Special Project(YLXKZX-NND-012)
文摘Feline herpesvirus type 1(FHV-1)is a common and highly contagious pathogen in domestic cats that causes upper respiratory tract infections and ocular diseases.Accurate and rapid diagnosis of FHV-1 infections is essential for effective disease management and control.In this study,we developed an immunochromatographic lateral flow(ICLF)assay for the rapid and accurate detection of FHV-1-specific antibodies.The assay was founded upon the successful expression and purification of a 26 kDa recombinant glycoprotein B-glycoprotein D(gB-gD)fusion protein,which served as the primary antigen for the test.Rigorous testing for specificity and cross-reactivity confirmed the strip’s ability to exclusively detect FHV-1 antibodies,even in the presence of a variety of other feline viruses.The assay demonstrated excellent precision,reproducibility across dilutions,and long-term stability,retaining efficacy for 24 months during storage.Furthermore,clinical sample analysis revealed exceptional sensitivity(97%)and specificity(100%).In conclusion,the ICLF strip developed in this study represents a reliable,highly specific,and stable diagnostic tool for the rapid detection and management of FHV-1 infections in cats.
