[Determinación of islet-cell antibodies in different groups of diabetics (author's transl)].

The discovery of islet-cell antibodies (ICA) has served to reinforce the theory that the pathogenesis of diabetes is immunologic. These antibodies have been found in the serum of diabetics who also had other autoimmune diseases and in that of most insulin dependent diabetics. ICA were detected by an indirect immunofluorescent technique using human pancreas tissue as a substrate. In this study two human islet cell adenomas were employed; their cell composition was analyzed by means of this technique with antihormone antibodies marked with fluorescein. Serum from 74 diabetic patients and 45 normal controls were studied using this substrate. Twenty-three of the 56 insulin-dependent diabetics were in the first clinical stage of the disease; 18 of them (78%) were positive for ICA. The other 33 insulin-dependent diabetics had the disease for over 3 years; six of these (36%) were positive. Anticellular antibodies were detected also in two of the 18 patients who were not insulin-dependent (5%). There was only one case of positivity among the controls (2%). These figures are similar to those of previous studies. It has been shown that the incidence of islet-cell antibodies drops rapidly after the fifth week of the disease; it depends primarily on the stage of development and has little to do with the age of the patient at the onset of the disease. Knowledge about these antibodies makes it easier to classify diabetics and to arrive at a prognosis regarding possible later insulin-dependence. These antibodies may be a consequence or even the cause of the destruction of the pancreatic islets provoked by a viral infection and perhaps determined by a predisposing genetic factor.