Molecular biological analysis for patheogenesis of Insulin Autoimmune Syndrome

在过去的20年中，日本报告了212例胰岛素自身免疫综合征（IAS），而自Hirata等人于1970年首次描述该疾病以来，白种人中只有大约20例病例。以下标题是我们在几年来对IAS进行的一系列研究中发现的。1)胰岛素自身免疫综合征的胰岛素自身抗体分为多克隆和单克隆；东亚人多克隆应答的发生率相对较高，而高加索人单克隆应答的发生率更高。2)hla - drb1链第74位的谷氨酸被认为是IAS中产生多克隆胰岛素自身抗体所必需的，而hla - drb1链同一位置的丙氨酸可能在产生单克隆胰岛素自身抗体中起重要作用。3)根据上述发现，研究T细胞受体Vbeta的使用情况，以了解其使用是否均匀，以及T细胞是否存在受限制的CDR3区域。因此，胰岛素反应的T细胞受体主要使用Vbeta8。

There have been 212 reported cases of insulin autoimmune syndrome (IAS) during the past 20 years in Japan, compared with only about 20 cases in Caucasians since Hirata et al, first described the disease in 1970. The following headings were what we found from the serial studies of IAS in the couples of years.1) Insulin autoantibodies in the insulin autoimmune syndrome were divided into polyclonal and monoclonal ; the incidence of polyclonal responders was relatively high among East Asians, whereas the monoclonal responders were more prevalent in Caucasians.2) Glutamate at position 74 in the HLA-DRB1-chain was presumed to be essential to the production of polyclonal insulin autoantibodies in IAS,whereas alanine at the same position of the HLA-DRB1-chain might be important in the production of monoclonal insulin autoantibodies.3) From the findings described above, T cell reccptor Vbeta usage was investigated in order to know whether the usage was uniform or not and whether the T cell had a restricted CDR3 region on not. So for, the insulin-reacted T cell receptor had a dominant Vbeta8 usage.