1型糖尿病患儿血清干扰素γ诱导蛋白10水平的变化及其意义

The changes of serum interferon-inducible protein-lO levels in children with type 1 diabetes mellitus

目的观察趋化因子干扰素γ诱导蛋白10(IP-10)在儿童1型糖尿病(T1DM)发病中的变化。方法用 ELISA 法检测50例 T1DM 患儿和30例健康儿童的血清 IP-10水平,根据自身抗体存在与否、自身抗体阳性种类数及不同病程对 IP-10进行分组比较。结果 T1DM 患儿血清 IP-10水平[(367±131)ng/L]显著高于对照组[(133±43)ng/L],差异有统计学意义(t=9.49,P<0.01)。其中自身抗体阳性组 IP-10[(385±147)ng/L]和自身抗体阴性组 IP-10[(311±101)ng/L]均高于对照组(t=8.99,P<0.01;t=8.67,P<0.01),但该两组间差异无统计学意义。1种、2种和3种自身抗体阳性患儿血清 IP-10水平差异无统计学意义(F=1.46,P>0.05)。初发组和病程≥2年组的 T1DM 患儿血清 IP-10均高于对照组(t=10.34,P<0.01;t=4.36,P<0.01),而病程≥2年组血清 IP-10水平低于初发组(t=4.30,P<0.01)。结论 T1DM 患儿血清 IP-10水平高于对照组,血清 IP-10水平不受自身抗体阳性存在与否、自身抗体阳性种类多少的影响,随病程延长,血清IP-10水平逐渐下降。

Objective Type 1 diabetes mellitus （T1DM） has been recognized as a T-cell mediated autoimmune disease, the migration of immune effector cells from the bloodstream into the pancreatic islet may be a crucial step in the pathogenesis of T1DM. However, a clinically applicable method for measuring pancreatic β-cell specific T-cell function in cases of T1DM has not been established. Interferon-inducible protein-10 （IP-10） is a chemokine that promotes the migration of activated T cells. The aim of this study was to investigate the role of IP-10 in the pathogenesis of childhood T1DM. Methods Serum IP-10 levels were measured by ELISA in 50 children with T1DM and 30 healthy children, and the levels of autoantibodies [ glutamic acid decarboxylase （ GAD）, isle tcell antibody （ ICA）, insulin autoantibody （IAA） and tyrosine phosphatase （IA-2）] in diabetic children were measured as well. Comparisons were made among groups divided by autoantibody condition and disease period. Results The serum levels of IP-10 in patients with T1DM [ （367 ± 130） ng/L] were significantly higher than those in controls [ （ 133 ± 43） ng/L] （ t = 9. 49, P 〈0. 01 ）. IP-10 levels in autoantibody positive [ （385 ± 147）ng/L] and negative diabetic children [ （311 ± 101 ） ng/L] were both higher than those in controls, but the difference was not significant. The serum levels of IP-10 among diabetic children who were positive for 1, 2 or 3 kinds of autoantibody did not show significant difference （ F = 1.46, P 〉 0. 05 ）. IP-10 levels in newly diagnosed patients were much higher than those with disease period longer than 2 years （t = 4. 30, P 〈0.01 ）, although both of them were higher than those in controls. Conclusion The serum levels of IP-10 in children with TIDM were higher than those in controls, but they were not affected by either the presence of autoantibody or the number of positive autoantibodies. IP-10 levels decreased gradually with disease period prolonged.