Etiology pathogenesis
Etiology & pathogenesis
Etiology pathogenesis Viral infection( Coxsackie EBV, measles, mumps Milk proteins (lactoalbumin, 1 Environment - casein,β- casein, lactoglobulin Cow insulin Chemical agents AutoantigenS: GadIA-2, Insulin
Etiology & pathogenesis Viral infection（Coxsackie， EBV，measles，mumps） Milk proteins (lactoalbumin, －casein, - casein, lactoglobulin) Cow insulin Autoantigens: GAD，IA-2，Insulin Environment Chemical agents .Autoimmune 1
Etiology pathogenesis Monozygotic twins-IDDM(30-50%) .HLA DR3/DR4DDM(70%) 2. Genetics. Aspartic acid on position 57 of HLA-DQ B chain protective effect for TIDM arginine on position 52 of HLA-dQ a chain increases susceptibility to DM
Etiology & pathogenesis 2.Genetics •Monozygotic twins→IDDM (30－50％) •HLA DR3/DR4 →IDDM (70%) •Aspartic acid on position 57 of HLA-DQ chain protective effect for T1DM •Arginine on position 52 of HLA-DQ chain increases susceptibility to DM
Genetic susceptibility Environmental factors Isletβ-cell Antigen Monocyte, Phagocyte TNF-O IL-1B NO ThI celll TNF-a TNF-B( HLA-I1 TNF-a,TNFβ,IFN IFN Phagocyte,NK, Ctl β cell apoptosis Oxygen free radica,NO个↑, Oxygen free radical, NOT adhesion molecule, perforin Fas I, Insulin growth regeneration l. defense and repair defect
Antigen Islet -cell Genetic susceptibility Environmental factors Monocyte, Phagocyte Th1 cell Phagocyte,NK,CTL TNF-, IL-1 HLA-II NO TNF- TNF- IFN- TNF-,TNF-,IFN- Oxygen free radical, NO, Oxygen adhesion molecule,perforin free radical, NO Fas, Insulin, growth regeneration, defense and repair defect cell apoptosis
Pathophysiology Insufficient insulin secretion Decrease in glucose utilization Decreased metabolic synthesis Insufficient energy hyperglycemia Polyphagia Glucosuria -+Osmotic diuresis polyuria Emaciation Chronic dehydration Thirst and polydipsia
Pathophysiology Insufficient insulin secretion Decrease in glucose utilization Decreased metabolic synthesis Insufficient energy hyperglycemia Polyphagia Glucosuria Osmotic diuresis Polyuria Emaciation Chronic dehydration Thirst and Polydipsia