Dyrberg T
Acta Endocrinol Suppl (Copenh). 1986;280:1-29.
The present review describes the autoimmune aspects of the pathogenesis of insulin-dependent diabetes mellitus (IDDM) in man and in the BB rat, and the requirements for effective prevention. Using a xenotypic mouse islet cell antiserum, we demonstrated the presence of antibodies reacting specifically with the pancreatic beta cells and recognizing a Mr 40,000 plasma membrane glycoprotein. The existence of beta cell-specific surface antigens, which hypothetically could act as targets in an autoimmune response, might explain the selective disappearance of the beta cells in IDDM. The BB rat spontaneously develops an insulin-dependent diabetes much like IDDM in man. Diabetes in BB rats, as in IDDM of humans, is associated with a high incidence of islet cell surface antibodies. These antibodies precipitate a Mr 64,000 protein from lysates of islets of Langerhans isolated from normal rats. In the BB rat, islet cell antibodies precede the appearance of insulitis and the clinical onset of diabetes. We investigated the beneficial effects of early treatment with low doses of cortisone on diabetes in the BB rat, because comparable experiments in children with newly diagnosed IDDM have given inconclusive results. In the BB rat there was no effect on the incidence or severity of diabetes or on the diabetes-related, islet cell-directed autoimmune phenomena. However, immunologic intervention that prevents IDDM from developing in potentially susceptible individuals is a promising area for research on this disease.
本综述描述了人类和BB大鼠中胰岛素依赖型糖尿病（IDDM）发病机制的自身免疫方面，以及有效预防的要求。使用异种型小鼠胰岛细胞抗血清，我们证明了存在与胰腺β细胞特异性反应并识别一种分子量为40,000的质膜糖蛋白的抗体。β细胞特异性表面抗原的存在，假设其可作为自身免疫反应的靶标，可能解释了IDDM中β细胞的选择性消失。BB大鼠自发发展出一种与人类IDDM非常相似的胰岛素依赖型糖尿病。与人类IDDM一样，BB大鼠的糖尿病与胰岛细胞表面抗体的高发生率相关。这些抗体从正常大鼠分离的胰岛裂解物中沉淀出一种分子量为64,000的蛋白质。在BB大鼠中，胰岛细胞抗体先于胰岛炎的出现和糖尿病的临床发作。我们研究了低剂量可的松早期治疗对BB大鼠糖尿病的有益作用，因为在新诊断的IDDM儿童中进行的类似实验结果尚无定论。在BB大鼠中，对糖尿病的发生率或严重程度以及与糖尿病相关的、针对胰岛细胞的自身免疫现象均无影响。然而，防止IDDM在潜在易感个体中发展的免疫干预是该疾病研究的一个有前景的领域。
