Koczwara Kerstin, Schenker Mike, Schmid Sandra, Kredel Katharina, Ziegler Anette-Gabriele, Bonifacio Ezio
Diabetes Research Institute and 3rd Medical Department, Krankenhaus München-Schwabing, Germany.
Clin Immunol. 2003 Feb;106(2):155-62. doi: 10.1016/s1521-6616(02)00040-2.
It is suggested that a T-helper cell 2 (Th2) shift and Th2 spreading of autoimmunity following immunization with beta-cell antigen causes diabetes protection. To address this, antibody titer and subclass to insulin, glutamic acid decarboxylase (GAD)65, IA-2, and IA-2beta proteins were measured by radiobinding assays in untreated or immunized female nonobese diabetic mice. Untreated nonobese diabetic mice developed autoantibodies to insulin (IAA), but not GAD or IA-2/IA-2beta, and IAA-positive mice had increased diabetes risk (P < 0.001). IAA were IgG1 and IgG2b. In immunized mice, IgG1 and lesser IgG2b insulin antibodies were promoted by subcutaneous injection of insulin plus incomplete Freund's adjuvant, insulin plus Montanide ISA 720, and glucagon plus incomplete Freund's adjuvant, but not by incomplete Freund's adjuvant plus GAD65, IA-2beta, or phenylethanolamine N-methyltransferase, or adjuvant alone. Diabetes incidence was significantly reduced in immunized groups with elevated insulin antibody (IA) responses. Spreading of antibody responses to GAD or IA-2/IA-2beta following immunization was rare, and antibody epitope spreading was only detected in IA-2beta immunized mice. Humoral autoimmunity in nonobese diabetic mice is, therefore, limited to IAA with Th2 subclass phenotype and is associated with increased diabetes risk. This contrasts the diabetes protection provided by immunization protocols that promote this response and suggests that Th2 immunity may not be the principal regulator of beta-cell destruction in autoimmune diabetes.
有人提出,在用β细胞抗原免疫后,T辅助细胞2(Th2)偏移和自身免疫的Th2扩散可导致糖尿病得到保护。为了验证这一点,通过放射结合试验在未处理或免疫的雌性非肥胖糖尿病小鼠中测量了针对胰岛素、谷氨酸脱羧酶(GAD)65、IA-2和IA-2β蛋白的抗体滴度和亚类。未处理的非肥胖糖尿病小鼠产生了针对胰岛素(IAA)的自身抗体,但未产生针对GAD或IA-2/IA-2β的自身抗体,且IAA阳性小鼠患糖尿病的风险增加(P < 0.001)。IAA为IgG1和IgG2b。在免疫小鼠中,皮下注射胰岛素加不完全弗氏佐剂、胰岛素加Montanide ISA 720以及胰高血糖素加不完全弗氏佐剂可促进IgG1和较少的IgG2b胰岛素抗体产生,但不完全弗氏佐剂加GAD65、IA-2β或苯乙醇胺N-甲基转移酶,或单独使用佐剂则无此作用。胰岛素抗体(IA)反应升高的免疫组中糖尿病发病率显著降低。免疫后对GAD或IA-2/IA-2β的抗体反应扩散很少见,且仅在IA-2β免疫的小鼠中检测到抗体表位扩散。因此,非肥胖糖尿病小鼠的体液自身免疫仅限于具有Th2亚类表型的IAA,且与糖尿病风险增加相关。这与促进这种反应的免疫方案所提供的糖尿病保护形成对比,表明Th2免疫可能不是自身免疫性糖尿病中β细胞破坏的主要调节因子。