Insulin and IGF-1 receptors, nitrotyrosin and cerebral neuronal deficits in two young patients with diabetic ketoacidosis and fatal brain edema.
Gray and white matter structural deficits may accompany type 1 diabetes. Earlier experimental studies have demonstrated neuronal deficits associated with impaired neurotrophic support, inflammation and oxidative stress. In this study we demonstrate in two patients with histories of poorly controlled type 1 diabetes and fatal brain edema of ketoacidosis neuronal deficits associated with a decreased presence of insulin and IGF-1 receptors and accumulation of nitrotyrosin in neurons of affected areas and the choroid plexus. The findings add support to the suggested genesis of T1DM encephalopathy due to compromised neurotrophic protection, oxidative stress, inflammation and neuronal deficits, as demonstrated in T1DM encephalopathy in the BB/Wor-rat.
Hoffman
William H
WH
Department of Pediatrics, Section of Pediatric Endocrinology, Medical College of Georgia, Augusta, GA, USA. whoffman@mail.mcg.edu
Andjelkovic
Anuska V
AV
Zhang
Weixian
W
Passmore
Gregory G
GG
Sima
Anders A F
AA
D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D001929:Brain Edema / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007328:Insulin / Q000096:biosynthesis / Q000172:deficiency*; D017526:Receptor, IGF Type 1 / Q000096:biosynthesis / Q000172:deficiency*; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000096:biosynthesis / Q000172:deficiency
D015415:Biomarkers; D007328:Insulin; C002744:3-nitrotyrosine; D014443:Tyrosine; D017526:Receptor, IGF Type 1