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T-Cell Responses to Islet Antigens in Phenotypic Type2Diabetic Patients

Author: LiangHuiYing
Tutor: ZhouZhiGuang
School: Central South University
Course: Clinical
Keywords: T-LADA Type2Diabetes ELISPOT Islet β Cell Function
CLC: R587.1
Type: Master's thesis
Year: 2013
Downloads: 2
Quote: 0
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Abstract


Objective:Latent autoimmune diabetes in adults is considered to be a T-cell-mediated autoimmune disease. However, identification of patients is based commonly on autoantibody (Ab) detection. In this study, we investigated the possibility of identifying a new type of LADA, T-LADA from phenotypic Ab-type2diabetic patients by enzyme-linked immunospot (ELISPOT).Methods:Abs against glutamic acid decarboxylase (GAD), insulinoma-associated protein-2(IA-2) and zinc transpoter8(ZnT8) were measured in phenotypic T2D patients. Thirty-four Ab+T2D patients and31Ab-T2D patients were enrolled for T-cell assay of responses to GAD65and C peptide (CP) by ELISPOT. Based on their immunological status (Ab+T+, Ab+T-, Ab-T+and Ab-T-),9patients with T cell+and8age-, sex-and Ab-matched patients with T cell-were followed up for15months.Results:(1) Eight of31Ab-T2D patients were demonstrated interferon (IFN)-y secreting T cells by ELISPOT (3cases reactive to GAD alone,4reactive to CP alone and1reactive to both GAD and CP), as opposed to16of34Ab+phenotypic T2D patients positive for islet antigens (2reactive to GAD alone,9reactive to CP alone and5reactive to both GAD and CP).(2) Independent of Ab status, T cell+phenotypic T2D patients did not display significantly different fasting C-peptide (FCP), postprandial C-peptide (2hCP) and△CP (2hCP-FCP) levels as compared with T cell" patients, whereas Ab+patients demonstrated significant lower FCP than Ab-patients (P=0.033). Significant differences (P=0.023) were still observed between Ab+and Ab-groups for FCP, even data were adjusted for BMI and duration of diabetes.(3) There were no significant differences among the four groups (Ab+Tf Ab+T-, Ab-T+and Ab-T-) for FCP,2hCP and△CP levels.(4)There were no significant changes of FCP,2hCP and△CP levels in T+and T-groups at the15months follow-up point.Conclutions:(1) We have identified a group of adult autoimmune phenotypic T2D patients who are Ab-T+and thus would not be detected using Ab testing alone.(2) Ab-T+patients don’t show more severe β cell lesion. Larger-size sample and longitudinal follow-up are needed.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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