联合胰岛抗原反应性 T 细胞和自身抗体检测对 1 型糖尿病的诊断价值。
Diagnostic value of combined islet antigen-reactive T cells and autoantibodies assays for type 1 diabetes mellitus.
机构信息
National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Metabolism and Endocrinology, The First People's Hospital of Huaihua, Huaihua, Hunan, China.
出版信息
J Diabetes Investig. 2021 Jun;12(6):963-969. doi: 10.1111/jdi.13440. Epub 2020 Nov 27.
AIMS/INTRODUCTION: Type 1 diabetes mellitus is a T cell-mediated autoimmune disease. However, the determination of the autoimmune status of type 1 diabetes mellitus relies on islet autoantibodies (Abs), as T-cell assay is not routinely carried out. This study aimed to investigate the diagnostic value of combined assay of islet antigen-specific T cells and Abs in type 1 diabetes mellitus patients.
MATERIALS AND METHODS
A total of 54 patients with type 1 diabetes mellitus and 56 healthy controls were enrolled. Abs against glutamic acid decarboxylase (GAD), islet antigen-2 and zinc transporter 8 were detected by radioligand assay. Interferon-γ-secreting T cells responding to glutamic acid decarboxylase 65 and C-peptide (CP) were measured by enzyme-linked immunospot.
RESULTS
The positive rate for T-cell responses was significantly higher in patients with type 1 diabetes mellitus than that in controls (P < 0.001). The combined positive rate of Abs and T-cell assay was significantly higher than that of Abs assay alone (85.2% vs 64.8%, P = 0.015). A significant difference in fasting CP level was found between the T and T groups (0.07 ± 0.05 vs 0.11 ± 0.09 nmol/L, P = 0.033). Furthermore, levels of fasting CP and postprandial CP were both lower in the Ab T group than the Ab T group (fasting CP 0.06 ± 0.05 vs 0.16 ± 0.12 nmol/L, P = 0.041; postprandial CP 0.12 ± 0.13 vs 0.27 ± 0.12 nmol/L, P = 0.024).
CONCLUSIONS
Enzyme-linked immunospot assays in combination with Abs detection could improve the diagnostic sensitivity of autoimmune diabetes.
目的/引言：1 型糖尿病是一种 T 细胞介导的自身免疫性疾病。然而，1 型糖尿病自身免疫状态的确定依赖于胰岛自身抗体（Abs），因为 T 细胞检测并未常规进行。本研究旨在探讨胰岛抗原特异性 T 细胞和 Abs 联合检测在 1 型糖尿病患者中的诊断价值。
材料与方法
共纳入 54 例 1 型糖尿病患者和 56 名健康对照者。采用放射配体法检测谷氨酸脱羧酶（GAD）、胰岛抗原-2 和锌转运体 8 的 Abs。通过酶联免疫斑点法检测对谷氨酸脱羧酶 65 和 C 肽（CP）反应的干扰素-γ分泌 T 细胞。
结果
1 型糖尿病患者 T 细胞反应的阳性率明显高于对照组（P < 0.001）。Abs 和 T 细胞联合检测的阳性率明显高于单独 Abs 检测（85.2%比 64.8%，P = 0.015）。T 组和 T 组之间空腹 CP 水平有显著差异（0.07 ± 0.05 比 0.11 ± 0.09 nmol/L，P = 0.033）。此外，Ab T 组空腹 CP 和餐后 CP 水平均低于 Ab T 组（空腹 CP 0.06 ± 0.05 比 0.16 ± 0.12 nmol/L，P = 0.041；餐后 CP 0.12 ± 0.13 比 0.27 ± 0.12 nmol/L，P = 0.024）。
结论
酶联免疫斑点法联合 Abs 检测可提高自身免疫性糖尿病的诊断敏感性。
Zotero 插件