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- W3022796449 abstract "Isabelle Douek and colleagues (May 29, p 1850)1Douek IF Leech NJ Gillmor HA Bingley PJ Gale EAM Children with type-1 diabetes and their unaffected siblings have fewer symptoms of asthma.Lancet. 1999; 353: 1850Summary Full Text Full Text PDF PubMed Scopus (76) Google Scholar and the EURODIAB ACE substudy group2EURODIAB ACE Substudy 2 Study GroupDecreased prevalence of atopy in diabetic children.Diabetologia. 1998; 41 (abstr).: A22Google Scholar suggest that low incidence of asthma among patients with type-1 diabetes mellitus is more than coincidental. The T-helper (Th)1/Th2 model suggests that the two diseases are unlikely to co-exist in the same individual because they are dominant immune response is driven by interleukin 2, interferon gamma, and cell-mediated immunity. By contrast, allergic asthma is a Th2 disease in which interleukin 4, interleukin 5, and IgE dominate the immune response. The distinct polarisation of type-1 diabetes and allergic asthma, however, provide a unique opportunity to re-examine the underlying pathogenesis of both diseases and to offer new approaches in the prevention of these diseases.Since the progression of the Th1 or Th2 immune response is closely linked to HLA markers of the host, the susceptible gene for one disease might be a resistant gene for the other disease. Thus, molecular engineering may be possible to alter the susceptibility of individuals who are prone to autoimmune disease such as type 1 diabetes.In an independent metabolic study,3Szczeklik A Pieton R Sieradzki J Alteration in both insulin release and its hypoglycemic effects in atopic bronchial asthma.J Allergy Clin Immunol. 1980; 66: 424-427Summary Full Text PDF PubMed Scopus (13) Google Scholar Szczeklik and colleagues showed that glycaemic responses to tolbutamide or insulin were significantly different between children with atopic asthma and controls. They conclude that more economic use of insulin and reduction in hypoglycaemic effects of cate-cholamines in bronchial asthma might explain why asthmatics rarely develop diabetes. It is tempting to speculate that there is a hidden link between a genetic marker for neurohorminal control and immunological markers that together drive the host to develop either Th1 or Th2 disease.In the Th1/Th2 model, cross-regulation of the Th1 immune response to suppress Th2 disease, or vice versa, is now possible. For instance, bacille Calmette-Guèrin infection can suppress allergic sensitisation.4Herz U Gerhold K Gruber C et al.BCG infection suppresses allergic sensitization and development of increased airway reactivity in an animal model.J Allergy Clin Immunol. 1998; 102: 867-874Summary Full Text Full Text PDF PubMed Scopus (216) Google Scholar Likewise, treatment with interleukin 4 suppresses the onset of type-1 diabetes.5Cameron MJ Arreaza GA Zucker P et al.IL-4 prevents insulitis and insulin-dependent diabetes mellitus in nonobese diabetic mice by potentiating of regulatory T helper-2 cell function.J Immunol. 1997; 159: 4686-4692PubMed Google Scholar The question now is, how long we need to maintain such immunotherapy in patients and what are its long-term consequences?Whatever the answers turn out to be, any immunological intervention has to start early, at the onset or even before the onset of the disease. This early intervention is particularly important for type-1 diabetes, because the effect of therapy will not be felt once the β-cell mass in the diseased pancreas is substantially diminished. Isabelle Douek and colleagues (May 29, p 1850)1Douek IF Leech NJ Gillmor HA Bingley PJ Gale EAM Children with type-1 diabetes and their unaffected siblings have fewer symptoms of asthma.Lancet. 1999; 353: 1850Summary Full Text Full Text PDF PubMed Scopus (76) Google Scholar and the EURODIAB ACE substudy group2EURODIAB ACE Substudy 2 Study GroupDecreased prevalence of atopy in diabetic children.Diabetologia. 1998; 41 (abstr).: A22Google Scholar suggest that low incidence of asthma among patients with type-1 diabetes mellitus is more than coincidental. The T-helper (Th)1/Th2 model suggests that the two diseases are unlikely to co-exist in the same individual because they are dominant immune response is driven by interleukin 2, interferon gamma, and cell-mediated immunity. By contrast, allergic asthma is a Th2 disease in which interleukin 4, interleukin 5, and IgE dominate the immune response. The distinct polarisation of type-1 diabetes and allergic asthma, however, provide a unique opportunity to re-examine the underlying pathogenesis of both diseases and to offer new approaches in the prevention of these diseases. Since the progression of the Th1 or Th2 immune response is closely linked to HLA markers of the host, the susceptible gene for one disease might be a resistant gene for the other disease. Thus, molecular engineering may be possible to alter the susceptibility of individuals who are prone to autoimmune disease such as type 1 diabetes. In an independent metabolic study,3Szczeklik A Pieton R Sieradzki J Alteration in both insulin release and its hypoglycemic effects in atopic bronchial asthma.J Allergy Clin Immunol. 1980; 66: 424-427Summary Full Text PDF PubMed Scopus (13) Google Scholar Szczeklik and colleagues showed that glycaemic responses to tolbutamide or insulin were significantly different between children with atopic asthma and controls. They conclude that more economic use of insulin and reduction in hypoglycaemic effects of cate-cholamines in bronchial asthma might explain why asthmatics rarely develop diabetes. It is tempting to speculate that there is a hidden link between a genetic marker for neurohorminal control and immunological markers that together drive the host to develop either Th1 or Th2 disease. In the Th1/Th2 model, cross-regulation of the Th1 immune response to suppress Th2 disease, or vice versa, is now possible. For instance, bacille Calmette-Guèrin infection can suppress allergic sensitisation.4Herz U Gerhold K Gruber C et al.BCG infection suppresses allergic sensitization and development of increased airway reactivity in an animal model.J Allergy Clin Immunol. 1998; 102: 867-874Summary Full Text Full Text PDF PubMed Scopus (216) Google Scholar Likewise, treatment with interleukin 4 suppresses the onset of type-1 diabetes.5Cameron MJ Arreaza GA Zucker P et al.IL-4 prevents insulitis and insulin-dependent diabetes mellitus in nonobese diabetic mice by potentiating of regulatory T helper-2 cell function.J Immunol. 1997; 159: 4686-4692PubMed Google Scholar The question now is, how long we need to maintain such immunotherapy in patients and what are its long-term consequences? Whatever the answers turn out to be, any immunological intervention has to start early, at the onset or even before the onset of the disease. This early intervention is particularly important for type-1 diabetes, because the effect of therapy will not be felt once the β-cell mass in the diseased pancreas is substantially diminished." @default.
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- W3022796449 title "Asthma and diabetes" @default.
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