Department of Internal Medicine (I), Osaka Medical College, Japan.
Immunol Lett. 2011 Sep 30;139(1-2):80-6. doi: 10.1016/j.imlet.2011.05.003. Epub 2011 May 17.
Fulminant type 1 diabetes is a novel subtype of type 1 diabetes characterized by a remarkably abrupt onset of insulin-deficient hyperglycemia. An accelerated immune reaction has been suggested as the cause of markedly rapid beta cell loss in this disease, but the precise mechanism has not been clarified. We analyzed the expression of cytotoxic T lymphocyte antigen 4 (CTLA-4) in CD4(+) helper T-cells in 16 patients with fulminant type 1 diabetes, 14 patients with type 1A diabetes, 10 patients with type 2 diabetes and 20 normal control subjects. There was a significant reduction in CTLA-4 expression in CD4(+) helper T-cells from patients with fulminant type 1 diabetes (P<0.05) compared with the other three groups. Low CTLA-4 expression was also observed in both CD4(+)CD25(high) T-cells and CD4(+)CD25(-) T-cells. There was a significant negative correlation between the proliferation of CD4(+)CD25(-) T-cells and the levels of CTLA-4. Intracellular expression of CTLA-4 in CD4(+) helper T-cells was not correlated with two CTLA-4 polymorphisms. In conclusion, the expression of CTLA-4 in CD4(+) helper T-cells was low in patients with fulminant type 1 diabetes.
暴发性 1 型糖尿病是 1 型糖尿病的一种新型亚型，其特征为胰岛素缺乏性高血糖急剧发作。有人提出，在这种疾病中，加速的免疫反应是导致β细胞迅速丧失的原因，但确切的机制尚未阐明。我们分析了 16 例暴发性 1 型糖尿病患者、14 例 1 型 A 糖尿病患者、10 例 2 型糖尿病患者和 20 名正常对照者的 CD4+辅助 T 细胞中细胞毒性 T 淋巴细胞相关抗原 4（CTLA-4）的表达。与其他三组相比，暴发性 1 型糖尿病患者的 CD4+辅助 T 细胞中 CTLA-4 的表达明显降低（P<0.05）。在 CD4+CD25（高）T 细胞和 CD4+CD25（-）T 细胞中也观察到 CTLA-4 表达降低。CD4+CD25（-）T 细胞的增殖与 CTLA-4 水平呈显著负相关。CD4+辅助 T 细胞内 CTLA-4 的表达与两种 CTLA-4 多态性无关。总之，暴发性 1 型糖尿病患者 CD4+辅助 T 细胞中 CTLA-4 的表达降低。
