Identification of autoantibody-negative autoimmune type 2 diabetic patients.
Identification of autoantibody-negative autoimmune type 2 diabetic patients.
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DOI：
10.2337/dc10-0579
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发表时间：
2011-01
期刊：
影响因子：
16.2
通讯作者：
Palmer JP
中科院分区：
文献类型：
--
作者：
Brooks-Worrell BM;Reichow JL;Goel A;Ismail H;Palmer JP
胰岛自身免疫在1型糖尿病的发病机制中早已被认识到，并且越来越多地被认为是2型糖尿病发病机制的一个组成部分。胰岛反应性T细胞和自身抗体已在1型糖尿病中得到证实，而2型糖尿病中的胰岛自身免疫仅限于胰岛自身抗体。在这项研究中，我们调查了胰岛反应性T细胞是否也可能存在于2型糖尿病患者中，以及胰岛反应性T细胞与β细胞功能的关系。成人表型2型糖尿病患者（n = 36）筛选胰岛反应性T细胞反应使用细胞免疫印迹和5个胰岛自身抗体（胰岛细胞抗体，GADA，胰岛素自身抗体，胰岛素瘤相关蛋白-2自身抗体，和锌转运蛋白自身抗体）。我们根据成人表型2型糖尿病患者的免疫状态确定了4个亚组（Ab−T−、Ab+T−、Ab−T+和Ab+T+）。Ab−T+2型糖尿病患者表现出与Ab+T+2型糖尿病患者相似的T细胞应答。数据经BMI、胰岛素抵抗和糖尿病持续时间校正。各组间空腹和胰高血糖素刺激的C肽反应有显著性差异（P < 0.02）。T细胞对胰岛蛋白的反应也被证明波动小于自身抗体反应。我们已经确定了一组成人自身免疫表型2型糖尿病患者谁是Ab−T+，因此不会使用自身抗体检测单独检测。我们的结论是胰岛自身免疫可能是更普遍的成人表型2型糖尿病患者比以前估计的。
Islet autoimmunity has long been recognized in the pathogenesis of type 1 diabetes and is becoming increasingly acknowledged as a component in the pathogenesis of type 2 diabetes. Islet reactive T cells and autoantibodies have been demonstrated in type 1 diabetes, whereas islet autoimmunity in type 2 diabetes has been limited to islet autoantibodies. In this study, we investigated whether islet reactive T cells might also be present in type 2 diabetic patients and how islet reactive T cells correlate with β-cell function. Adult phenotypic type 2 diabetic patients (n = 36) were screened for islet reactive T-cell responses using cellular immunoblotting and five islet autoantibodies (islet cell antibody, GADA, insulin autoantibody, insulinoma-associated protein-2 autoantibody, and zinc transporter autoantibody). We identified four subgroups of adult phenotypic type 2 diabetic patients based on their immunological status (Ab−T−, Ab+T−, Ab−T+, and Ab+T+). The Ab−T+ type 2 diabetic patients demonstrated T-cell responses similar to those of the Ab+T+ type 2 diabetic patients. Data were adjusted for BMI, insulin resistance, and duration of diabetes. Significant differences (P < 0.02) were observed among groups for fasting and glucagon-stimulated C-peptide responses. T-cell responses to islet proteins were also demonstrated to fluctuate less than autoantibody responses. We have identified a group of adult autoimmune phenotypic type 2 diabetic patients who are Ab−T+ and thus would not be detected using autoantibody testing alone. We conclude that islet autoimmunity may be more prevalent in adult phenotypic type 2 diabetic patients than previously estimated.
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影响因子：
7.7
作者：
Brooks-Worrell, BM;Juneja, R;Palmer, JP
通讯作者：
Palmer, JP
影响因子：
2.2
作者：
Brooks-Worrell, Barbara;Warsen, Adelaide;Palmer, Jerfy P.
通讯作者：
Palmer, Jerfy P.
DOI：
10.1073/pnas.0705894104
发表时间：
2007-10-23
影响因子：
11.1
作者：
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通讯作者：
Hutton, John C.
影响因子：
16.2
作者：
Lohmann, T;Seissler, J;Scherbaum, WA
通讯作者：
Scherbaum, WA
影响因子：
9.8
作者：
Juneja, R;Hirsch, IB;Palmer, JP
通讯作者：
Palmer, JP