Elfving A Maria, Lindberg Bengt A, Landin-Olsson M, Hampe Christine S, Lernmark Ake, Ivarsson Sten A
Department of Pediatrics, Lund University, Lund, Sweden.
Autoimmunity. 2003 Mar;36(2):111-5. doi: 10.1080/0891693031000073109.
Blood group incompatibility is a risk factor for type 1 diabetes. Our aim was to test the hypothesis that islet cell autoantibodies, as markers for beta cell autoimmunity, are increased in cord blood from newborns with a diagnosis of blood group incompatibility. Using the diagnosis register of the Malmö University Hospital we obtained cord blood from 151 children with ABO immunization, 311 children with hyperbilirubinemia and a control group of 320 other children born during the same time period. The cord blood samples were analyzed for islet cell antibodies (ICA) by indirect immunofluorescence and autoantibodies against the Islet Cell Antigen-2 (IA-2Ab) and the 65 kDa isoform of glutamic acid decarboxylase (GAD65Ab) by standard radioligand binding assays. The prevalence of ICA was increased compared to controls (0.6%) not only in children with ABO immunization (4.0%, p = 0.02), but also in newborn children with hyperbilirubinemia (4.2%, p = 0.003). The prevalence of IA2Ab, but not of GAD65Ab, was increased in children with ABO immunization (3.3%) compared to the hyperbilirubinemia group without incompatibility (0.6%, p = 0.04), or the controls (0.3%, p = 0.02). Our findings that hyperbilirubinemia is associated with an increased prevalence of ICA, and blood group incompatibility with both ICA and IA-2, suggests that intra-uterine factors may be associated with islet cell autoimmunity.
血型不相容是1型糖尿病的一个风险因素。我们的目的是检验这样一个假设：作为β细胞自身免疫标志物的胰岛细胞自身抗体，在诊断为血型不相容的新生儿脐带血中会增加。利用马尔默大学医院的诊断登记册，我们获取了151名患有ABO免疫反应儿童、311名患有高胆红素血症儿童的脐带血，以及同期出生的320名其他儿童组成的对照组的脐带血。通过间接免疫荧光法分析脐带血样本中的胰岛细胞抗体（ICA），并通过标准放射性配体结合试验分析针对胰岛细胞抗原-2（IA-2Ab）和65 kDa谷氨酸脱羧酶同工型（GAD65Ab）的自身抗体。与对照组（0.6%）相比，不仅患有ABO免疫反应的儿童（4.0%，p = 0.02），而且患有高胆红素血症的新生儿（4.2%，p = 0.003）中ICA的患病率都有所增加。与无血型不相容的高胆红素血症组（0.6%，p = 0.04）或对照组（0.3%，p = 0.02）相比，患有ABO免疫反应的儿童中IA2Ab的患病率增加（3.3%），但GAD65Ab的患病率没有增加。我们的研究结果表明，高胆红素血症与ICA患病率增加相关，血型不相容与ICA和IA-2都相关，这表明宫内因素可能与胰岛细胞自身免疫有关。
