vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2026-1-212-226vtio-1993Research ArticleРегенеративная медицина и клеточные технологииRegenerative Medicine and Cell TechnologiesНовое поколение методов терапии в лечении сахарного диабета 1-го типаEmerging therapeutic strategies for type 1 diabeteshttps://orcid.org/0009-0005-8700-6070ЦелоусоваЮ. М.TselousovaYu. M.

Целоусова Юлия Максимовна

603087, Нижний Новгород, ул. Богдановича, д. 8. Тел. (910) 099-18-25

Yulia Tselousova

8, Bogdanovicha str., Nizhny Novgorod, 603087

Phone: 8 (910) 099-18-25

tselousova.julia@yandex.ruЛуговаяЛ. А.LugovayaL. A.

Нижний Новгород

Nizhniy Novgorod

КучинД. М.KuchinD. M.

Нижний Новгород

Nizhniy Novgorod

ВасильчиковаЕ. А.VasilchikovaE. A.

Нижний Новгород

Nizhniy Novgorod

ЕрмаковаП. С.ErmakovaP. S.

Нижний Новгород

Nizhniy Novgorod

КашинаА. В.KashinaА. V.

Нижний Новгород

Nizhniy Novgorod

ЗагайновВ. Е.ZagainovV. E.

Нижний Новгород

Nizhniy Novgorod

ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииРоссияPrivolzhsky Research Medical UniversityRussian FederationГБУЗ НО «Нижегородская областная клиническая больница имени Н.А. Семашко»Semashko Nizhny Novgorod Regional Clinical HospitalФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России; ГБУЗ НО «Нижегородская областная клиническая больница имени Н.А. Семашко»Privolzhsky Research Medical University; Nizhny Novgorod Regional Clinical Oncology Center202631032026281212226Copyright © Целоусова Ю.М., Луговая Л.А., Кучин Д.М., Васильчикова Е.А., Ермакова П.С., Кашина А.В., Загайнов В.Е., 20262026Целоусова Ю.М., Луговая Л.А., Кучин Д.М., Васильчикова Е.А., Ермакова П.С., Кашина А.В., Загайнов В.Е.Tselousova Y.M., Lugovaya L.A., Kuchin D.M., Vasilchikova E.A., Ermakova P.S., Kashina А.V., Zagainov V.E.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1993

Современные медицинские исследования идентифицируют сахарный диабет (СД) 1-го типа как одну из наиболее актуальных проблем глобального здравоохранения в связи с устойчивой тенденцией к росту заболеваемости – до 500 000 новых случаев в год. Существующие на данный момент подходы к лечению не могут обеспечить оптимальный уровень гликемии, так как направлены в основном на компенсацию дефицита эндогенного инсулина, что может приводить к значительному снижению качества жизни пациентов. В течение долгого времени ведется поиск метода лечения, позволяющего быстро, безопасно и надежно вылечить СД 1-го типа. Учитывая нехватку данных, необходимых для полного понимания причины развития аутоиммунной реакции, лежащей в основе данного заболевания, современная наука не может предложить этиотропного лечения, приводящего к полному выздоровлению. Существует большое количество разработок, воздействующих на различные патогенетические механизмы СД 1-го типа и направленных на поддержание оптимального уровня метаболизма глюкозы. Их цель – это профилактика, замедление прогрессирования заболевания (отсрочка клинической стадии), а также облегчение контроля гликемии у пациентов с СД 1-го типа. Несмотря на значительный прогресс в разработке новых терапевтических стратегий при СД 1-го типа, ни один из инновационных подходов пока не достиг стадии широкого внедрения в клиническую практику. Основными лимитирующими факторами являются продолжительные сроки, необходимые для проведения полного цикла клинических испытаний, а также необходимость устранения выявляемых в процессе исследований ограничений. В обзоре представлены основные современные подходы к лечению СД 1-го типа, а также включены данные клинических исследований наиболее известных разработок в инсулинотерапии, иммунотерапии и клеточной терапии СД 1-го типа. Проанализированы основные преимущества и недостатки с практической и экономической точек зрения. Подходы, описанные в обзоре, демонстрируют наибольшую эффективность и с большой вероятностью могут быть использованы для лечения в ближайшем будущем.

Modern medical research identifies type 1 diabetes mellitus (T1D) as one of the most pressing global health challenges, with the incidence steadily increasing by up to 500,000 new cases annually. Current treatment approaches do not provide optimal glycemic control, as they are mainly aimed at compensating for endogenous insulin deficiency, which can significantly compromise patients’ quality of life. For a long time, researchers have sought a treatment strategy capable of achieving a rapid, safe, and reliable cure for T1D. Yet, due to the insufficient understanding of the mechanisms driving the autoimmune response underlying this condition, modern medicine has not been able to develop an etiotropic therapy that could ensure complete recovery. A wide range of therapeutic developments targeting different pathogenetic mechanisms of T1D are currently underway, all aimed at supporting optimal glucose metabolism. Their objectives include preventing or slowing disease progression (delaying the onset of the clinical stage) and facilitating glycemic control in affected patients. Despite substantial progress, none of these innovative strategies has yet reached widespread clinical application. The primary obstacles remain the lengthy timelines required to complete full cycles of clinical trials and the need to address limitations revealed during the research process. This review presents the leading modern approaches to T1DM therapy, with a focus on insulin therapy, immunotherapy, and cell-based strategies. Clinical trial data are analyzed, highlighting both advantages and limitations from practical and economic perspectives. The approaches discussed represent the most promising avenues and are expected to play a central role in future treatment of T1DM.

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The authors declare that there are no conflicts of interest present.