title: Altered immune profile from pre-diabetes to manifestation of type 1 diabetes.
abstract: BACKGROUND
  While the mechanisms leading to β-cell destruction and clinical onset of T1D are still unclear, the composition of the immune profile is probably important for the outcome of immune activity. The aim of this study was to investigate the composition and possible changes of the immunological profile, spontaneously and following stimulation with the autoantigens GAD65, and HSP60, at high-risk and T1D onset and further to 8 months post diagnosis.
  
  
  METHODS
  Fifteen first-degree relatives of T1D patients with a high risk of developing the disease within five years, 25 children approximately four days and 8 months after diagnosis of T1D and 16 healthy children were included in the study. Cytokines (IL-1β, -6, -7, -10, -13, -17, IFN-γ and TNF-α) and chemokines (CCL2, -3, -4, -5 and CXCL10) associated with Th1, Th2, Tr1 and inflammatory cells were detected in cell culture supernatants by Luminex-technique, and markers associated with regulatory T-cells (FOXP3, CTLA-4 and TGF-β) by real-time RT-PCR.
  
  
  RESULTS
  High-risk individuals differed in immunity from that seen in healthy and T1D children. High-risk individuals had a low TNF-α response and fewer responders from mitogen exposure as well as low spontaneous secretions of IL-13 compared to healthy children. High-risk individuals that later developed T1D, had a lower FOXP3 and CTLA-4 mRNA expression, following stimulation with GAD65, in combination with higher secretion of the pro-inflammatory chemokine CCL4.
  
  
  CONCLUSIONS
  Changes in immunity seen in individuals with high risk of developing T1D points to alterations/actions in the immune system already early in the pre-diabetic phase.
authors.affiliation: Division of Paediatrics & Diabetes Research Centre, Department of Clinical & Experimental Medicine, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Rydén
authors.forename: Maria
authors.initials: M
authors.lastname: Faresjö
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D018834:Chaperonin 60 / Q000378:metabolism*; D018925:Chemokines; D002648:Child; D002675:Child, Preschool; D016207:Cytokines; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000235:genetics / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism*; D005968:Glutamate Decarboxylase / Q000378:metabolism*; D006801:Humans; D008297:Male; D026901:Membrane Transport Proteins / Q000378:metabolism*; D024101:Mitochondrial Proteins / Q000378:metabolism*; D011236:Prediabetic State / Q000453:epidemiology / Q000235:genetics / Q000276:immunology* / Q000503:physiopathology; D060888:Real-Time Polymerase Chain Reaction; D013548:Sweden / Q000453:epidemiology; D050378:T-Lymphocytes, Regulatory; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D015854:Up-Regulation
chemical_list: D018834:Chaperonin 60; D018925:Chemokines; D016207:Cytokines; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; C060293:HSPD1 protein, human; D026901:Membrane Transport Proteins; D024101:Mitochondrial Proteins; C583905:SLC44A4 protein, human; D014409:Tumor Necrosis Factor-alpha; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2