初发Ⅰ型糖尿病循环HLA-DR抗原阳性的T细胞亚群的前瞻性研究

PROSPECTIVE RESEARCH ON CIRCULATING HLA-DR-ANTIGEN-BEARING T CELLS IN NEWLY DIAGNOSED TYPE I DIABETES

作者前瞻性观察7例初发Ⅰ型糖尿病病人,采用单克隆抗体,双色免疫荧光染色,流体细胞测定仪检测。发现初发Ⅰ型糖尿病人循环HLA-DR阳性T细胞从病程第1个月起显著增加,第2个月达到高峰,以后逐渐下降,在第5个月时恢复至正常水平。这一结果提示:Ⅰ型糖尿病发病后,胰岛B细胞的自身免疫损伤仍在继续,活性T细胞亚群的数目增加是一个有力的证据。这一结果也为临床早期使用免疫抑制剂,保护残留的胰岛B细胞功能提供了理论依据。

The pathogenic role of T cells in type I diabetes has been well established. The animal models of autoimmune type I diabetes were made by transfer of T cells from diabetic animals. It has been reported that there was an increased percentage of activated T cells in type I diabetes. To address the trend of activated T cells in the course of type I diabetes, 7 newly diagnosed patients were studied using anti-T cells monoclonal antibodies with dual colour analysis on flow cytometer. The percentage of activated T cells (judged by HLA-DR expression) increased at one month after diagnosis, reached a peak at the second month and declined towards the normal level at the fifth month. The activated T cells presented in type I diabetes in the course of five months were equally increased and declined among CD4and CD8 subsets. The results suggest that the autoimmune destruction of the islet cells still continues after the onset of the disease. The treatment of immunosuppression may be used at the time of diagnosis to preserve more function of the residual beta cells.