title: The effect of azathioprine, cyclosporine A and insulin on the in vitro lymphocyte-mediated cytotoxicity in type I diabetic patients.
abstract: Previously both specific and nonspecific immune reactions have been reported in patients with type I diabetes mellitus. In this study the effect of various immunosuppressive drugs and insulin was studied on in vitro lymphocyte-mediated cytotoxicity in 20 type I diabetic patients. Twenty sex- and age-matched healthy subjects served as controls. Human pancreas-extract (300 micrograms/ml protein)-coated, 51-Chromium labeled chicken erythrocytes were used as target cells and separated T-lymphocytes as effector cells with and without azathioprine 50 micrograms/50 microliters (Wellcome), Cyclosporine A 5 ng/50 microliters (Sandoz) and MC Actrapid insulin 0.1 IU/50 microliters (Novo). The degree of cytotoxicity was expressed with cytotoxic capacity: the number of maximal killed target cells. Simultaneously islet cell antibodies (ICA) in sera and the number of activated T-lymphocytes were assessed. Significant lymphocyte-mediated cytotoxicity was observed in the majority of type I diabetic patients (18/20), while no cytotoxicity was found in the control cases. The cytotoxicity decreased in all 16 patients using azathioprine or insulin, independently of ICA and HLA-DR positivity. The number of killed target cells was lowered considerably by Cyclosporine A in all 18 patients having cytotoxicity against pancreas-extract. Our observations reveal that Cyclosporine A proved to be the most effective immunosuppressive agent in vitro. It decreases not only the leucocyte migration inhibition as previously observed, but also the lymphocyte-mediated cytotoxicity, which represents the late stage of cellular immune reactions against pancreatic tissue.
authors.affiliation: 3rd Department of Medicine, Semmelweis Medical University, Budapest/Hungary.
authors.forename: M
authors.initials: M
authors.lastname: Horváth
authors.forename: M
authors.initials: M
authors.lastname: Varsányi
authors.forename: E
authors.initials: E
authors.lastname: Bándi
authors.forename: I
authors.initials: I
authors.lastname: Balázsi
authors.forename: L
authors.initials: L
authors.lastname: Romics
mesh_terms: D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000494:pharmacology*; D002648:Child; D016572:Cyclosporine / Q000494:pharmacology*; D003602:Cytotoxicity, Immunologic / Q000187:drug effects*; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D005260:Female; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D007328:Insulin / Q000494:pharmacology*; D007515:Islets of Langerhans / Q000276:immunology; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D010179:Pancreas / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D006684:HLA-DR Antigens; D007328:Insulin; D016572:Cyclosporine; D001379:Azathioprine