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新诊断的胰岛素依赖型糖尿病患儿谷氨酸脱羧酶自身抗体研究

[Autoantibodies to glutamate decarboxylase in children with newly detected insulin-dependent diabetes mellitus].

作者信息

Trofimenko E V, Zlobina E V, Lebedev N V, Martynova M I, Piliutik V F, Shchegol'kova T S, Zlobina E N, Dedov I I

出版信息

Probl Endokrinol (Mosk). 1994 Mar-Apr;40(2):18-21.

PMID:8197083
Abstract

Glutamic acid decarboxylase (GAD) is considered as target antigen in pancreatic beta cell autoimmunity. Two isoforms of GAD (islet and brain GAD) were detected recently. In circulation of approximately 80% of recently detected patients with insulin-dependent diabetes mellitus (IDDM) autoantibodies to brain GAD (bGAD) have been demonstrated. To detect autoantibodies to bGAD blood sera of 48 children aged 1 to 14, 36 of these with newly diagnosed IDDM, 2 with impaired glucose tolerance (IGT), 10 healthy controls, were tested. Indirect immunofluorescent staining of rat cerebellum cryoslices was carried out. The results were assessed using fluorescent microscopy and processed by statistical methods. Autoantibodies to bGAD were found in 30 out of 36 patients with IDDM: 83.3 +/- 12.4% (p = 95%), in 1 with IGT, and in none of controls. The fact that all controls were antibody-negative proves a high specificity of this immunological marker of IDDM. Family history or a younger age by the moment of diabetes onset were conductive to a higher prevalence of autoantibodies to GAD, each of these factors being unrelated to the other.

摘要

谷氨酸脱羧酶(GAD)被认为是胰腺β细胞自身免疫的靶抗原。最近检测到GAD的两种同工型(胰岛GAD和脑GAD)。在最近检测的胰岛素依赖型糖尿病(IDDM)患者中,约80%的患者血液中已证实存在针对脑GAD(bGAD)的自身抗体。对48名年龄在1至14岁的儿童的血清进行检测,其中36名是新诊断的IDDM患者,2名是糖耐量受损(IGT)患者,10名是健康对照者,以检测针对bGAD的自身抗体。对大鼠小脑冷冻切片进行间接免疫荧光染色。使用荧光显微镜评估结果并采用统计方法进行处理。在36名IDDM患者中有30名检测到针对bGAD的自身抗体:83.3±12.4%(p=95%),1名IGT患者检测到,而对照者均未检测到。所有对照者抗体均为阴性这一事实证明了这种IDDM免疫标志物具有高度特异性。糖尿病发病时的家族史或较年轻的年龄有利于GAD自身抗体的更高患病率,这些因素相互之间没有关联。

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