Association of cytomegalovirus infections with recurrence of humoral and cellular autoimmunity to islet autoantigens and of type 1 diabetes in a pancreas transplanted patient.
Association of type 1 diabetes and cytomegalovirus (CMV) is suspected and CMV infections have also been linked to increased risk of new onset post-transplantation diabetes. We monitored response to islet autoantigens, pancreatic endocrine function, and CMV infections in one type 1 diabetic patient receiving pancreas allograft. Time course analyses of levels of islet autoantibodies (Abs), IFN-gamma ELISPOT response, analysis of T cell function, levels of C peptide together with CMV pp65 antigenaemia and viraemia and graft biopsy histopathology were performed in comparison with a cohort of diabetic recipients. Evidence of autoimmune activation to GAD and IA2, modification of CD4(+) CD25hi T cells, loss of pancreatic function, concomitantly with multiple CMV infections and allograft rejection with peri-insulitis is provided. The parallel between metabolic outcome, initiation and progression of autoreactivity to islet autoantigens and early CMV infections after transplantation, suggests that persistent CMV infections may be relevant to the pathogenesis of type 1 diabetes.
Zanone
Maria M
MM
Department of Internal Medicine, University of Turin, Turin, Italy. mmz@libero.it
Favaro
Enrica
E
Quadri
Roberto
R
Miceli
Ilaria
I
Giaretta
Fulvia
F
Romagnoli
Renato
R
David
Ezio
E
Perin
Paolo Cavallo
PC
Salizzoni
Mauro
M
Camussi
Giovanni
G
D000328:Adult; D001324:Autoantigens; D015551:Autoimmunity; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral; D007515:Islets of Langerhans / Q000276:immunology*; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000276:immunology* / Q000473:pathology / Q000502:physiology; D012008:Recurrence
D001324:Autoantigens