Zorena Katarzyna, Myśliwska Jolanta, Myśliwiec Małgorzata, Balcerska Anna, Lipowski Paweł, Raczyńska Krystyna
Zakład Immunologii AM w Gdańsku.
Pediatr Endocrinol Diabetes Metab. 2007;13(1):27-31.
The objective of the study was to analyse levels IL-12 and to relate the findings to the clinical course of type 1 diabetes mellitus (DM1).
We examined a group of 102 children with DM1 and 39 healthy children (as the control). All the children with DM1 had their daily urine albumin excretion, HbA1c, C-peptide measured, 24hrs blood pressure monitoring and ophthalmologic examination. In accordance to the ophthalmologic examination and level IL-12 in the serum the diabetic children were divided into 3 groups: group A: IL-12>0 pg/ml; group B: IL-12=0 pg/ml; group C: IL-12=0 pg/ml and IL12>0 pg/ml. Serum levels of IL-12 and TNFalpha were measured by the immunoenzymatic ELISA method, Quan-tikine High Sensitivity Human by R&D Systems (USA).
Children of group A were characterized by significantly high level of IL-12 and by the absence of TNFalpha as compared with the children of group B, who had undetectable IL-12 along with high TNFalpha level. Additionally, children of group A had significantly lower urine albumin excretion and had only developed retinopathy. However, the children of group B not only had retinopathy, nephropathy but also arterial hypertension. The patients of group A were also analysed against the children of group C, who were characterized by high IL-12 level and some of them had also detectable TNFalpha, but without retinopathy and nephropathy.
The results of our study imply the existence of balance between IL-12 and TNFalpha in type 1 DM children, which seems to warrant the stage of disease without diabetic complications. However, the IL-12 domination tends to prevent or delay nephropathy development but does not protect from retinopathy.
本研究的目的是分析白细胞介素-12（IL-12）水平，并将研究结果与1型糖尿病（DM1）的临床病程相关联。
我们检查了102名DM1儿童和39名健康儿童（作为对照）。所有DM1儿童均进行了每日尿白蛋白排泄量、糖化血红蛋白（HbA1c）、C肽测量、24小时血压监测和眼科检查。根据眼科检查结果和血清中IL-12水平，将糖尿病儿童分为3组：A组：IL-12>0 pg/ml；B组：IL-12=0 pg/ml；C组：IL-12=0 pg/ml且IL-12>0 pg/ml。采用美国R&D Systems公司的免疫酶联ELISA法（Quantikine高灵敏度人试剂盒）测定血清IL-12和肿瘤坏死因子α（TNFα）水平。
与B组儿童相比，A组儿童的特点是IL-12水平显著升高且无TNFα，B组儿童的IL-12检测不到但TNFα水平较高。此外，A组儿童的尿白蛋白排泄量显著较低，仅出现视网膜病变。然而，B组儿童不仅有视网膜病变、肾病，还有动脉高血压。还将A组患者与C组儿童进行了分析，C组儿童的特点是IL-12水平较高，其中一些人也可检测到TNFα，但无视网膜病变和肾病。
我们的研究结果表明，1型糖尿病儿童中IL-12和TNFα之间存在平衡，这似乎保证了疾病处于无糖尿病并发症阶段。然而，IL-12占主导地位往往会预防或延缓肾病的发展，但不能预防视网膜病变。
