[Immunological features of fulminant type 1 diabetes].
OBJECTIVE
To investigate the immunological features of fulminant type 1 diabetes.


METHODS
Twenty patients with fulminant type 1 diabetes (F1D) were recruited based upon the criteria proposed by Hanafusa, and 40 patients with classical type 1 diabetes were matched with age, gender and duration for comparison. GADA, IA2A and ZnT8A were determined with radioligand assay, and GAD-reactive T cells were measured by enzyme-linked immunospot (ELISPOT) assay. The HLA-DQ were analyzed by sequence-based genotyping (SBT).


RESULTS
Eight of 20 patients with F1D were antibody-positive, including 7 GADA positive, 4 ZnT8A positive, and 3 both GADA and ZnT8A positive. The index of 3 GADA positive patients were less than 0.4 at first visit, two turned to be negative by two or three years. While the GADA index of the patient was 0.343 at onset and increased to 1.467 three years later. Among subjects with F1D (3/6) and classical type 1 diabetes (3/6), were recorded significant GAD-stimulated responses by ELISPOT assay. The frequencies of HLA-DQA1*0102-DQB1*0601 and DQA1*03-DQB1*0401 were significantly higher in F1D than those in classical type 1 diabetes (P = 0.005, P = 0.035, respectively).


CONCLUSIONS
Humoral and cellular immunoreactivity and susceptible HLA-DQ genotype existed in part of F1D patients, indicating autoimmunity may involve in the pathogenesis of F1D.
Diabetes Center, Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Hunan, China.
Chao
C
Zheng
Jian
J
Lin
Gan
G
Huang
Lin
L
Yang
Yi-yu
YY
Zhang
Wei-dong
WD
Zhou
Hai-feng
HF
Zhou
Ya-ling
YL
Yang
Zhi-hong
ZH
Che
Zhi-guang
ZG
Zhou
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000276:immunology; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000276:immunology*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006683:HLA-DQ Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D001323:Autoantibodies; D006683:HLA-DQ Antigens