Savilahti E, Saukkonen T T, Virtala E T, Tuomilehto J, Akerblom H K
Children's Hospital, I Department of Pediatrics, University of Helsinki, Finland.
Diabetes Care. 1993 Jul;16(7):984-9. doi: 10.2337/diacare.16.7.984.
To investigate the humoral immune response to cow's milk in pediatric patients with newly diagnosed IDDM.
We measured IgA, IgG, and IgM antibodies to the proteins of cow's milk and to beta-lactoglobulin by an enzyme-linked immunosorbent assay. Samples from 706 pediatric patients with newly diagnosed IDDM were available. We used two comparison groups: 105 patients < 7 yr old had an unrelated age-matched control subject, and samples from 456 3- to 14-yr-old nondiabetic siblings also were available.
Patients < 3 yr of age had a markedly higher median level of IgG and IgA antibodies to cow's milk compared with the control subjects (P = 0.03 and 0.002, respectively), IgG antibodies to beta-lactoglobulin also were higher (P = 0.03). Older groups of diabetic patients, 3.0-6.9 and 7.0-14.9 yr of age, had significantly higher levels of IgA antibodies to cow's milk and beta-lactoglobulin than the age-matched comparison groups of both unrelated control subjects and nondiabetic siblings, although the median values of the diabetic patients were closer to those of the comparison groups than in the youngest groups. Nondiabetic siblings had higher levels of IgA cow's milk antibodies than unrelated control subjects of similar ages (3-6.9 yr of age) (P = 0.03). The 14 siblings contracting IDDM during the follow-up showed no change in the levels of cow's milk or beta-lactoglobulin antibodies in relation to the clinical diagnosis.
The results indicate an abnormally strong humoral response to the proteins of cow's milk, particularly in young IDDM patients and, to a lesser extent, in their siblings. We infer that the proteins of cow's milk may trigger the autoimmune process of IDDM.
研究新诊断的儿童胰岛素依赖型糖尿病(IDDM)患者对牛奶的体液免疫反应。
我们采用酶联免疫吸附测定法检测了针对牛奶蛋白和β-乳球蛋白的IgA、IgG和IgM抗体。共有706例新诊断的儿童IDDM患者的样本可供检测。我们设立了两个对照组:105例年龄小于7岁的患者有年龄匹配的无关对照对象,并且还有456例3至14岁非糖尿病同胞的样本。
与对照对象相比,3岁以下的患者针对牛奶的IgG和IgA抗体的中位数水平显著更高(分别为P = 0.03和0.002),针对β-乳球蛋白的IgG抗体也更高(P = 0.03)。年龄较大的糖尿病患者组,即3.0至6.9岁和7.0至14.9岁的患者,针对牛奶和β-乳球蛋白的IgA抗体水平明显高于年龄匹配的无关对照对象和非糖尿病同胞的对照组,尽管糖尿病患者的中位数水平比最年轻组的患者更接近对照组。非糖尿病同胞针对牛奶的IgA抗体水平高于年龄相似(3至6.9岁)的无关对照对象(P = 0.03)。在随访期间患IDDM的14名同胞,其牛奶或β-乳球蛋白抗体水平与临床诊断无关,没有变化。
结果表明对牛奶蛋白存在异常强烈的体液反应,特别是在年轻的IDDM患者中,在其同胞中程度较轻。我们推断牛奶蛋白可能触发IDDM的自身免疫过程。