CAJ | 학술논문

目的:探讨羧基肽酶H抗体(CPH-Ab)阳性的成人隐匿性自身免疫性糖尿病(LADA)患者外周血T细胞免疫的特点.方法:选取CPH-Ab~+ LADA患者42例,2型糖尿病组(T2DM)患者20例和健康对照22例,分离外周血单个核细胞;自制人CPH蛋白,应用酶联免疫斑点(ELISPOT)技术检测并比较各组在CPH诱导下分泌IFN-γ的Th1和分泌IL-4的Th2细胞数,计算Th1与Th2比值(Th1/Th2).结果:与健康对照和T2DM比较,CPH-Ab~+ LADA患者的IFN-γ-T和IL-4-T细胞数无异常增多,Th1/Th2亦无统计学差异(P＞0.05);但22例短病程(＜3年)CPH-Ab~+患者的CPH-IL-4-Th2细胞数较T2DM患者和正常对照均显著升高(1.8 vs. 0.2 和0.3, 均P＜0.05),但未发现任何因素与该斑点数相关.各组间的T细胞针对植物血凝素的反应均无统计学差异.结论:CPH未直接诱导LADA的细胞免疫破坏反应,CPH反应性T细胞标志的可能是一进展相对缓慢的、胰岛β细胞的自身免疫过程.
목적:탐토최기태매H항체(CPH-Ab)양성적성인은닉성자신면역성당뇨병(LADA)환자외주혈T세포면역적특점.방법:선취CPH-Ab~+ LADA환자42례,2형당뇨병조(T2DM)환자20례화건강대조22례,분리외주혈단개핵세포;자제인CPH단백,응용매련면역반점(ELISPOT)기술검측병비교각조재CPH유도하분비IFN-γ적Th1화분비IL-4적Th2세포수,계산Th1여Th2비치(Th1/Th2).결과:여건강대조화T2DM비교,CPH-Ab~+ LADA환자적IFN-γ-T화IL-4-T세포수무이상증다,Th1/Th2역무통계학차이(P＞0.05);단22례단병정(＜3년)CPH-Ab~+환자적CPH-IL-4-Th2세포수교T2DM환자화정상대조균현저승고(1.8 vs. 0.2 화0.3, 균P＜0.05),단미발현임하인소여해반점수상관.각조간적T세포침대식물혈응소적반응균무통계학차이.결론:CPH미직접유도LADA적세포면역파배반응,CPH반응성T세포표지적가능시일진전상대완만적、이도β세포적자신면역과정.
Objective To explore the characteristics of T cell immunity in peripheral blood of patients with carboxypeptidase - H antibody (CPH-Ab). Methods Forty-two latent autoimmune diabetes in adults (LADA) patients with CPH-Ab~+ alone, 20 Type 2 diabetes mellitus patients (T2DM), and 22 healthy controls were selected and their peripheral blood mononuclear cells were isolated. Human recombinant carboxypeptidase (CPH) protein was expressed and further used as a stimulant in Enzyme-linked immunospot (ELISPOT) assay to detect IFN-γ-Th1 and IL-4-Th2 cells in the 3 groups. Th1/Th2 ratios were also calculated. CPH-Ab and glutamic acid decarboxylase antibody (GAD-Ab) were determined by radioligand assay. Results Compared with healthy controls and T2DM, IFN-γ-Th1 and IL-4-Th2 numbers did not increase significantly in CPH-Ab~+ group, nor did the Th1/Th2 ratios (P ＞0. 05). We further divided the CPH-Ab~+ patients into a short duration group (n = 22) and a long duration subgroup (n = 20) according to the duration of 3 years. CPH-IL-4-T in the short duration subgroup was significantly higher than that in T2DM and healthy controls (1. 8 vs. 0.2 and 0.3, both P ＜ 0. 05) and we did not find any factor that was significantly correlated with the IL-4 spots number. There were not any significant differences in T cell responses to phaseolus vulgaris agglutinin (PHA) among all groups (P＞0.05). Conclusion CPH does not directly involve in the cellular pathological mechanism of LADA. Anti-CPH immunity may be associated with more slowly aggressive beta cell autoimmunity.