T-cell function in anti-GAD65(+)diabetes with residual beta-cell function.
We have recently reported that in patients with anti-glutamic acid decarboxylase (GAD) 65(+)diabetes with residual beta-cell function, most with a 'high-titer' (>10U/ml) required insulin within 5 years, whereas most with a 'low-titer' (1.3-9.9U/ml) did not need insulin for over 15-20 years after the onset. We therefore examined T-cell function to evaluate the difference between the high-titer and low-titer groups. Interleukin (IL)-10 production upon polyclonal activation was significantly lower in the high-titer group than in the low-titer group. The serum level of interferon-inducible protein-10 (IP-10) was higher in the high-titer than the low-titer group. Although GAD65-reactive CD4(+)cells in the periphery were detected in both groups, a significant positive correlation between serum IP-10 level and the number of GAD65-reactive CD4(+)cells was observed only in the high-titer group. Therefore, it has been speculated that the co-existence of GAD65-reactive IFN-gamma-producing CD4(+)cells and a high serum IP-10 level may be important for rapid disease progression as seen in the high-titer group. Based upon these results, T-cell function is considered to be different between the high-titer and low-titer groups in anti-GAD65(+)diabetes with residual beta-cell function, supporting our previous findings regarding the clinical outcome of insulin-dependence in the two groups.
Suzuki
Ryuji
R
Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Shimada
Akira
A
Maruyama
Taro
T
Funae
Osamu
O
Morimoto
Jiro
J
Kodama
Keiichi
K
Oikawa
Yoichi
Y
Kasuga
Akira
A
Matsubara
Koichi
K
Saruta
Takao
T
Narumi
Shosaku
S
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology*; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood / Q000378:metabolism; D007515:Islets of Langerhans / Q000502:physiology*; D007527:Isoenzymes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology* / Q000378:metabolism
D007527:Isoenzymes; D016753:Interleukin-10; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2