Metabolic and immunological effects of cyclosporin in recently diagnosed type 1 diabetes mellitus.
Cyclosporin 5-10 mg/kg daily was given for 2-8 months to twelve recently diagnosed type 1 diabetics from a mean of 49 +/- SE 14 days after the start of insulin therapy, which was regulated to give near-normal blood glucose and haemoglobin A1c values. Mean insulin dosage dropped from 46 +/- 5 U/day before cyclosporin treatment to 16 +/- 4 U/day by the 7th month. Four patients had a complete remission and the insulin needs of four more were cut by half. The remaining four did not have remissions. Initial basal and glucagon-stimulated C peptide concentrations were higher in those who went into remission than in those who did not; they rose during cyclosporin treatment in the former but not in the latter. OKT4+ lymphocyte functions were suppressed in all patients and OKT4/OKT8 ratios declined. Anti-beta-cell autoimmunity, as indicated by lymphocyte-induced inhibition of insulin release from mouse islet cells, declined in all patients who went into remission. No consistent trend was observed for anti-islet cell antibodies. In forty-four similar, but non-randomised, recently diagnosed diabetics treated with insulin alone, the incidence of remission was 6%.
Assan
R
R
Feutren
G
G
Debray-Sachs
M
M
Quiniou-Debrie
M C
MC
Laborie
C
C
Thomas
G
G
Chatenoud
L
L
Bach
J F
JF
D000328:Adult; D001323:Autoantibodies / Q000096:biosynthesis; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D003524:Cyclosporins / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use; D007515:Islets of Langerhans / Q000276:immunology; D008214:Lymphocytes / Q000276:immunology; D008297:Male
D001323:Autoantibodies; D001786:Blood Glucose; D002096:C-Peptide; D003524:Cyclosporins; D007328:Insulin