title: T cell immunity to glutamic acid decarboxylase in fulminant type 1 diabetes without significant elevation of serum amylase.
abstract: We encountered three patients with fulminant type 1 diabetes whose serum amylase levels were not elevated and evaluated their immunological characteristics. Although all three patients had no antibodies to islet antigens including glutamic acid decarboxylase (GAD), GAD-reactive T lymphocytes were detected in two patients. Combined with the findings that human leukocyte antigen (HLA) class II haplotype associated with fulminant type 1 diabetes is the same as that of autoimmune type 1 diabetes, an immune process similar to autoimmune type 1 diabetes may be involved in at least a part of fulminant type 1 diabetes.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba, Yokohama, Kanagawa, Japan 227-8501.
authors.forename: Kanemi
authors.initials: K
authors.lastname: Aoki
authors.forename: Matsuo
authors.initials: M
authors.lastname: Taniyama
authors.forename: Chieko
authors.initials: C
authors.lastname: Nagayama
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000681:Amylases / Q000097:blood; D000911:Antibodies, Monoclonal / Q000494:pharmacology; D020126:Brefeldin A / Q000494:pharmacology; D018106:CD28 Antigens / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000201:enzymology / Q000378:metabolism; D002452:Cell Count; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000201:enzymology* / Q000276:immunology* / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D005968:Glutamate Decarboxylase / Q000235:genetics / Q000276:immunology*; D015804:HLA-DR4 Antigen / Q000235:genetics; D006239:Haplotypes; D015395:Histocompatibility Antigens Class I / Q000032:analysis / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000032:analysis / Q000276:immunology; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000276:immunology; D013601:T-Lymphocytes / Q000201:enzymology* / Q000276:immunology*; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal; D018106:CD28 Antigens; D015804:HLA-DR4 Antigen; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D011994:Recombinant Proteins; D020126:Brefeldin A; D007371:Interferon-gamma; D000681:Amylases; D005968:Glutamate Decarboxylase