diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13089diaendo-13089Research ArticleОбзорReviewАутологичная трансплантация гемопоэтических стволовых клеток как метод иммунной профилактики сахарного диабета 1 типа: возможности и перспективыAutologous hematopoietic stem cell transplantation as a method of immune prevention of type 1 diabetes mellitus: possibilities and prospectshttps://orcid.org/0000-0001-6567-6990ЧернаяМ. Е.ChernayaM. E.

Черная Мария Евгеньевна, ассистент 

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8 

Maria E. Chernaya, assistant

6-8 L’va Tolstogo street, 197022 St. Petersburg

mashaeatworld@gmail.comhttps://orcid.org/0000-0002-7755-7275ХалимовЮ. Ш.KhalimovY. Sh.

Халимов Юрий Шавкатович, д.м.н., профессор 

Scopus Author ID: 55531165300

Санкт-Петербург

Yuriy Sh. Khalimov, MD, PhD, Professor

Scopus Author ID: 55531165300

St. Petersburg

yushkha@gmail.comhttps://orcid.org/0000-0002-5189-9365ВолковаА. Р.VolkovaA. R.

Волкова Анна Ральфовна, д.м.н., профессор 

Scopus Author ID: 57200116986

Санкт-Петербург

Anna R. Volkova, MD, PhD, Professor

Scopus Author ID: 57200116986

St. Petersburg

volkovaa@mail.ruhttps://orcid.org/0000-0003-4295-1202ЛискерА. В.LiskerA. V.

Лискер Анна Владимировна

Санкт-Петербург

Anna V. Lisker, MD

St. Petersburg

a.lisker@mail.ruhttps://orcid.org/0000-0003-0936-9915НерсесянА. А.NersesyanA. A.

Нерсесян Артем Артурович, студент 

Санкт-Петербург

Artem A. Nersesyan, student

St. Petersburg

Artem_Nersesyan00@mail.ruhttps://orcid.org/0000-0003-2574-6418ОрловскаяА. Д.OrlovskayaA. D.

Орловская Анастасия Дмитриевна, клинический ординатор 

Санкт-Петербург

Anastasiya D. Orlovskaya, clinical resident

St. Petersburg

nastyeagle@yandex.ruhttps://orcid.org/0000-0001-8699-2482ПолушинА. Ю.PolushinA. Y.

Полушин Алексей Юрьевич, к.м.н., доцент 

Scopus Author ID: 57195962540

Санкт-Петербург

Alexey Yu. Polushin, MD, PhD, Associate Professor

Scopus Author ID: 57195962540

St. Petersburg

alexpolushin@yandex.ruhttps://orcid.org/0000-0002-3881-4486ЗаляловЮ. Р.ZalyalovY. R.

Залялов Юрий Ринатович, к.м.н. 

Scopus Author ID: 36497755400

Санкт-Петербург

Yuri R. Zalyalov, MD, PhD

Scopus Author ID: 36497755400

St. Petersburg

yz21@mail.ruhttps://orcid.org/0000-0002-9589-4136КулагинА. Д.KulaginA. D.

Кулагин Александр Дмитриевич, д.м.н., доцент 

ResearcherID: L-9795-2014;

Scopus Author ID: 7003340367

Санкт-Петербург

Alexander D. Kulagin, MD, PhD, Associate professor

ResearcherID: L-9795-2014;

Scopus Author ID: 7003340367

St. Petersburg

 

kulagingem@rambler.ruПервый Санкт-Петербургский государственный медицинский университет имени академика И.П. ПавловаРоссияPavlov UniversityRussian Federation202427062024273277286Copyright © Черная М.Е., Халимов Ю.Ш., Волкова А.Р., Лискер А.В., Нерсесян А.А., Орловская А.Д., Полушин А.Ю., Залялов Ю.Р., Кулагин А.Д., 20242024Черная М.Е., Халимов Ю.Ш., Волкова А.Р., Лискер А.В., Нерсесян А.А., Орловская А.Д., Полушин А.Ю., Залялов Ю.Р., Кулагин А.Д.Chernaya M.E., Khalimov Y.S., Volkova A.R., Lisker A.V., Nersesyan A.A., Orlovskaya A.D., Polushin A.Y., Zalyalov Y.R., Kulagin A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13089

Сахарный диабет 1 типа (СД1) — одно из наиболее распространенных аутоиммунных заболеваний, для лечения которого используется пожизненная инсулинотерапия. Нецелевые показатели гликемического контроля, которые отмечаются у 71% пациентов, приводят к формированию и прогрессированию осложнений СД, ранней инвалидизации и смертности. В связи с этим представляется актуальным поиск новых подходов к лечению и профилактике СД1. Проводятся исследования эффективности различных методов иммунопрофилактики развития СД1, в частности применения моноклональных антител. Так, для замедления развития клинической стадии СД1 в ноябре 2022 г. был одобрен теплизумаб. Изучаются перспективы применения новых вариантов трансплантации островковых клеток — в июне 2023 г. был одобрен препарат аллогенного донорского трансплантата β-клеток, полученного из поджелудочной железы доноров после смерти. Еще одним патогенетически обоснованным методом профилактики и лечения аутоиммунных заболеваний является высокодозная иммуносупрессивная терапия с аутологичной трансплантацией гемопоэтических стволовых клеток (ВИСТ-АТГСК). ВИСТ-АТГСК продемонстрировала свою эффективность и экономическую целесообразность в различных клинических испытаниях. В данном обзоре представлена актуальная информация по современным методам иммунопрофилактики СД1.

Type 1 diabetes mellitus (DM) is one of the most common autoimmune disease that is treated with lifelong insulin therapy. Non-target indicators of glycemic control, which are observed in 71% of patients, lead to the formation and progression of diabetes complications, early disability and mortality. In this regard, the search for new approaches to the treatment and prevention of type 1 DM seems to be relevant. Various methods of immunological prophylaxis for the development of type 1 DM have been studied, in particular, the use of monoclonal antibodies. Thus, in November 2022, teplizumab was approved to slow down the clinical progression of the stage of type 1 DM. The prospects for the use of new options for islet cell transplantation are being studied — in June 2023, an allogeneic donor β-cell transplant obtained from the pancreas of donors after death was approved. Another pathogenetically substantiated method for the prevention and treatment of autoimmune diseases is high-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (HDIT-HSCT). HDIT-HSCT demonstrated its effectiveness and cost-effectiveness in various clinical trials. This review provides up-to-date information on modern methods of immunological prophylaxis of type 1 DM.

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Pediatr Endocrinol Rev. 2020;17(Suppl 1):198-209. doi: https://doi.org/10.17458/per.vol17.2020.tol.epidemiologychildtype1diabetesTuomilehto J, Ogle GD, Lund-Blix NA, Stene LC. Update on Worldwide Trends in Occurrence of Childhood Type 1 Diabetes in 2020. Pediatr Endocrinol Rev. 2020;17(Suppl 1):198-209. doi: https://doi.org/10.17458/per.vol17.2020.tol.epidemiologychildtype1diabetesPang H, Luo S, Xiao Y, et al. Emerging Roles of Exosomes in T1DM. Front Immunol. 2020;11:593348. doi: https://doi.org/10.3389/fimmu.2020.593348Pang H, Luo S, Xiao Y, et al. Emerging Roles of Exosomes in T1DM. Front Immunol. 2020;11:593348. doi: https://doi.org/10.3389/fimmu.2020.593348Дедов И.И., Шестакова М.В., Викулова О.К., и др. 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