Peakman M, Hussain M J, Millward B A, Leslie R D, Vergani D
Department of Immunology, King's College School of Medicine and Dentistry, London, UK.
Diabet Med. 1990 May;7(4):327-30. doi: 10.1111/j.1464-5491.1990.tb01399.x.
Levels of activated T-lymphocytes are characteristically increased in recently diagnosed patients with Type 1 diabetes and remain elevated up to 6 months after diagnosis. To determine whether insulin treatment has a role in initiating or maintaining this activation 12 patients were studied at diagnosis and again 1, 5, and 70 days after the start of insulin therapy. Levels of activated T-lymphocytes were found to be elevated at diagnosis (9.7 +/- 1.6% (+/- SD)) before insulin treatment compared with normal control subjects (4.2 +/- 1.1%; p less than 0.001). One day after starting insulin therapy, the level of activated T-lymphocytes had not changed but by day 5 it had fallen significantly (7.6 +/- 1.9%; p less than 0.05) compared with pre-treatment levels. By day 70, activated T-lymphocytes were returning towards the high levels found before treatment. Investigation of the phenotype of the activated T-lymphocytes showed that there was an increase in the percentage of activated cells expressing the CD8 (suppressor/cytotoxic) phenotype at 70 days compared with pre-treatment values (p less than 0.02). These results show that elevated levels of activated T-lymphocytes found in recently diagnosed Type 1 diabetes are not a result of insulin treatment. Treatment may, however, have a role in maintaining T-lymphocyte activation and modifying the distribution of functional subsets of the activated cells.
在新诊断的1型糖尿病患者中，活化T淋巴细胞水平通常会升高，并在诊断后长达6个月内一直保持升高。为了确定胰岛素治疗在引发或维持这种活化过程中是否起作用，对12例患者在诊断时以及胰岛素治疗开始后的第1、5和70天进行了研究。结果发现，与正常对照受试者（4.2±1.1%）相比，胰岛素治疗前诊断时活化T淋巴细胞水平升高（9.7±1.6%（±标准差）；p<0.001）。开始胰岛素治疗1天后，活化T淋巴细胞水平未发生变化，但到第5天时，与治疗前水平相比显著下降（7.6±1.9%；p<0.05）。到第70天时，活化T淋巴细胞水平又恢复到治疗前的高水平。对活化T淋巴细胞表型的研究表明，与治疗前相比，第70天时表达CD8（抑制/细胞毒性）表型的活化细胞百分比增加（p<0.02）。这些结果表明，新诊断的1型糖尿病患者中活化T淋巴细胞水平升高并非胰岛素治疗的结果。然而，治疗可能在维持T淋巴细胞活化以及改变活化细胞功能亚群的分布方面起作用。
