Coxsackie B Virus-Induced Autoimmunity in Type 1 Diabetes Mellitus: Mechanisms and Emerging Prevention Strategies
DOI:
https://doi.org/10.35516/jmj.v60i2.3769الكلمات المفتاحية:
Coxsackie B virus، Type 1 diabetes، Beta cell autoimmunity، Viral persistence، Prevention strategiesالملخص
داء السكري من النوع الأول (T1DM) هو مرض مناعي ذاتي يتميز بتدمير خلايا بيتا البنكرياسية. لقد تورط فيروس Coxsackie B (CVB) كمحفز بيئي رئيسي في تطوير T1DM. تهدف هذه المراجعة إلى تجميع المعرفة الحالية المتعلقة بالمناعة الذاتية التي يسببها CVB في T1DM، مع التركيز على الآليات المعنية والاستراتيجيات الناشئة للوقاية. تم إجراء مراجعة شاملة للمقالات التي راجعها النظراء المنشورة بين عامي 2004 و2024. تم تحديد المصادر الرئيسية باستخدام قواعد البيانات مثل PubMed، وScopus، وGoogle Scholar، مع التركيز على الدراسات التي تناقش التفاعل بين CVB والمناعة الذاتية. تسلط المراجعة الضوء على العديد من الآليات التي يساهم من خلالها CVB في المناعة الذاتية لخلايا بيتا، وخاصة التقليد الجزيئي، حيث تحاكي البروتينات الفيروسية مستضدات خلايا بيتا، مما يؤدي إلى استجابات الخلايا التائية ذاتية التفاعل. بالإضافة إلى ذلك، يُحدث CVB تأثيرات سامة للخلايا مباشرة ويحافظ على العدوى المستمرة منخفضة المستوى داخل خلايا بيتا، مما يؤدي إلى التهاب مزمن وخلل تدريجي في خلايا بيتا. وتشمل استراتيجيات الوقاية الناشئة لقاحات CVB والأدوية المضادة للفيروسات، والتي تظهر إمكاناتها في النماذج قبل السريرية ولكنها تواجه تحديات تتعلق بالسلامة والتوقيت. تهدف علاجات تعديل المناعة، مثل اللقاحات المسببة للتسامح وعلاجات الخلايا التائية التنظيمية، إلى استعادة التحمل المناعي، على الرغم من أنها تحمل أيضًا قيودًا. يعد النهج متعدد الأوجه الذي يستهدف كلاً من الثبات الفيروسي وتنظيم المناعة أمرًا ضروريًا لمنع تطور T1DM الناجم عن CVB. تعد مبادرات الصحة العامة التي تركز على الاكتشاف المبكر والتدخل في المجموعات السكانية المستعدة وراثيًا أمرًا بالغ الأهمية للتخفيف من خطر الإصابة بحالة المناعة الذاتية هذه.
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