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1.
Rev. chil. endocrinol. diabetes ; 11(2): 62-68, abr. 2018. graf
Article in Spanish | LILACS | ID: biblio-914895

ABSTRACT

Aim: Analyze mi-146a and miR-155 expression and its correlation with the apoptosis of lymphocytes T in T1D and control patient. Patients and Methodology: 17 T1D patients (5 children between 8-14 yr and 12 adults between 19-29 yr). Activated and not activated peripheral mononuclear cells were studied were studied. Cellular activation with anti-CD3 and primary culture with interleukyne-2 by 5 days. Apoptosis assays through flow cytometry. miRNA through Taqman probes. Statistical analysis through Kruskal-Wallis and post-hoc Dunn's test. Results: Composition of virgin and memory T CD4 cells showed significant differences for stimulus response in control group (p = 0,0004). Increased memory cells count in control group activated by 7 days than basal (p = 0,0047). For early apoptosis differences were observed in days 3 and 7 with and without activation (p = 0,001). AICD apoptosis showed increases in control group after re-stimulation through TCR (p= 0,03). miR-146a expression was lower in recent-onset T1D children vs recent-onset DM1 adults (p = 0,0167). Conclusion: This study shows a differential miR-146a expression in T1D children with respect to T1D adult patients, diminished AICD mechanism in T1D and altered CD4+CD45RA-CD45R0+ memory cells generation in T1D adult patients.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , T-Lymphocytes/immunology , Apoptosis/immunology , Diabetes Mellitus, Type 1/immunology , MicroRNAs/genetics , MicroRNAs/immunology , Diabetes Mellitus, Type 1/genetics , Immunologic Memory
2.
Arch. endocrinol. metab. (Online) ; 62(1): 34-40, Jan.-Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-887623

ABSTRACT

ABSTRACT Objective The aim of this research was to analyze the expression profile of miR-155, miR-146a, and miR-326 in peripheral blood mononuclear cells (PBMC) of 47 patients with type 1 diabetes mellitus (T1D) and 39 control subjects, as well as the possible association with autoimmune or inflammatory markers. Subjects and methods Expression profile of miRs by means of qPCR using TaqMan probes. Autoantibodies and inflammatory markers by ELISA. Statistical analysis using bivariate correlation. Results The analysis of the results shows an increase in the expression of miR-155 in T1D patients in basal conditions compared to the controls (p < 0.001) and a decreased expression level of miR-326 (p < 0.01) and miR-146a (p < 0.05) compared T1D patients to the controls. miR-155 was the only miRs associated with autoinmmunity (ZnT8) and inflammatory status (vCAM). Conclusion Our data show a possible role of miR-155 related to autoimmunity and inflammation in Chilean patients with T1D.


Subject(s)
Humans , Child , MicroRNAs/metabolism , Diabetes Mellitus, Type 1/metabolism , Autoantibodies/immunology , Autoantibodies/metabolism , Enzyme-Linked Immunosorbent Assay , Biomarkers , Autoimmunity/immunology , Case-Control Studies , Diabetes Mellitus, Type 1/immunology , Diabetes Mellitus, Type 1/blood , Real-Time Polymerase Chain Reaction , Inflammation/immunology , Inflammation/metabolism
3.
J. appl. oral sci ; 25(2): 217-226, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-841185

ABSTRACT

Abstract Objective The aim of this study was to compare the prevalence of periodontal pathogens, systemic inflammatory mediators and lipid profiles in type 1 diabetes children (DM) with those observed in children without diabetes (NDM), both with gingivitis. Material and methods Twenty-four DM children and twenty-seven NDM controls were evaluated. The periodontal status, glycemic and lipid profiles were determined for both groups. Subgingival samples of periodontal sites were collected to determine the prevalence of periodontal microorganisms by PCR. Blood samples were collected for IL-1-β, TNF-α and IL-6 analysis using ELISA kits. Results Periodontal conditions of DM and NDM patients were similar, without statistical differences in periodontal indices. When considering patients with gingivitis, all lipid parameters evaluated were highest in the DM group; Capnocytophaga sputigena and Capnocytophaga ochracea were more prevalent in the periodontal sites of DM children. “Red complex” bacteria were detected in few sites of DM and NDM groups. Fusobacterium nucleatum and Campylobacter rectus were frequently found in both groups. Similar levels of IL-1-β, TNF-α and IL-6 were detected in DM and NDM children. Conclusion Clinical and immunological profiles are similar between DM and NDM children. The presence of Capnocytophaga sputigena and Capnocytophaga ochracea were associated with gingivitis in DM children.


Subject(s)
Humans , Male , Female , Child , Adolescent , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/microbiology , Gingivitis/epidemiology , Gingivitis/microbiology , Periodontium/microbiology , Brazil/epidemiology , Capnocytophaga/isolation & purification , Cholesterol/blood , Dentition, Permanent , Diabetes Mellitus, Type 1/immunology , Enzyme-Linked Immunosorbent Assay , Gingivitis/immunology , Interleukin-1beta/blood , Interleukin-6/blood , Periodontal Index , Polymerase Chain Reaction , Statistics, Nonparametric , Tooth, Deciduous/microbiology , Triglycerides/blood , Tumor Necrosis Factor-alpha/blood
4.
Rev. chil. endocrinol. diabetes ; 9(1): 15-18, ene. 2016. tab
Article in Spanish | LILACS | ID: biblio-831338

ABSTRACT

Background: Type 1 diabetes mellitus and celiac disease share common genetic and immunological aspects and celiac disease is more common among type 1 diabetic patients. Aim: To determine the frequency of anti endomysial and anti transglutaminase antibodies among patients with type 1 diabetes. Material and Methods: Anti endomysialantibodies determined by indirect immunofluorescence an anti transglutaminase antibodies determined by ELISA were measured in 410 serum samples of patients with type 1 diabetes. Results: Seventy one samples (17 percent) had positive anti transglutaminase antibodies. Among these, 17 had also positive anti endomysial antibodies. In 11 of these 17 patients, the presence of celiac disease was confirmed. Conclusions: Among patients with type 1 diabetes mellitus, the frequency of celiac disease is three times higher than in the general population.


Subject(s)
Humans , Male , Adolescent , Female , Child , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/immunology , Celiac Disease/epidemiology , Celiac Disease/immunology , Antibodies, Anti-Idiotypic/immunology , Enzyme-Linked Immunosorbent Assay , Fluorescent Antibody Technique, Indirect , Transglutaminases/immunology
5.
Rev. chil. endocrinol. diabetes ; 9(4): 125-129, 2016. ilus
Article in Spanish | LILACS | ID: biblio-1291571

ABSTRACT

The worldwide increased incidence of type 1 diabetes (T1D) and the decreased genotypes that confer increased risk to T1D indicate a strong environmental impact on the disease. These mechanisms could occur through epigenetic modifications that operate on several gene expression patterns (methylation and acetylation, among others). An alternative mechanism of gene expression inhibition are the microRNAs families. These small noncoding RNAs bind the of mRNAs, downregulating and can downregulate the expression of multiple genes. In this review we discussed the role of certain miRNAs in three characteristics observed in T1D, such as inflammation, autoimmunity and apoptosis.


Subject(s)
Humans , MicroRNAs/genetics , Diabetes Mellitus, Type 1/genetics , Autoimmunity , Apoptosis/genetics , MicroRNAs/immunology , MicroRNAs/metabolism , Diabetes Mellitus, Type 1/immunology , Diabetes Mellitus, Type 1/metabolism , Epigenomics , Inflammation/genetics
6.
Rev. méd. Chile ; 143(8): 1042-1049, ago. 2015. ilus
Article in Spanish | LILACS | ID: lil-762671

ABSTRACT

Type 1A diabetes (DM1A) is an autoimmune disease that comprises 10% of patients with diabetes mellitus. Its frequency is gradually increasing in countries like Mexico. Patients with DM1A commonly have hypothyroidism, Addison disease, celiac disease and less common diseases such as polyglandular syndrome. These diseases are related to susceptibility genes such as HLA, CTLA-4 and PTPN22, which induce central and peripheral immunologic tolerance. This review article emphasizes the importance of searching other autoimmune diseases in patients with DM1A, to improve their prognosis and quality of life.


Subject(s)
Animals , Humans , Autoimmune Diseases , Diabetes Mellitus, Type 1 , Addison Disease/immunology , Autoimmune Diseases/diagnosis , Autoimmune Diseases/genetics , Autoimmune Diseases/immunology , Celiac Disease/immunology , Diabetes Mellitus, Type 1/genetics , Diabetes Mellitus, Type 1/immunology , Immune Tolerance , Polyendocrinopathies, Autoimmune/immunology
7.
Rev. chil. endocrinol. diabetes ; 8(2): 52-56, abr. 2015. tab
Article in Spanish | LILACS | ID: lil-797212

ABSTRACT

Background: Cytotoxic T lymphocyte antigen-4 (CTLA-4) molecule is an important regulator of T cell activation involved in the down-regulation of immune response. Their polymorphisms +49 A/G and CT60 have been suggested to confer susceptibility to autoimmune endocrine disorders. The aim of this study was to determine the association of CTLA-4 gene polymorphisms with T1D in the Chilean population. We also wanted to study if the combined haplotypes of +49 A/G and CT60 had an impact on risk for T1D. Methods: To evaluate the impact of allelic variants CT60 and +49 A/G SNPs were studied in a Chilean population, including 248 T1D patients and 160 controls. Genotypes of both polymorphisms of CTLA-4 gene were determinate by PCR-restriction fragment polymorphism (PCRRFLP).Results: No statistical differences were observed when comparing patients with diabetes and controls for both CTLA-4 genotypes. However, the haplotype analysis between CT60 and +49 A/G showed an interesting combination of risk conformed by G*G combination with an OR of 1.648 [1.19- 2.28], (p = 0.002). Conclusions: The G*G haplotype could be a risk marker in patients with T1D in Chilean population.


Subject(s)
Humans , /genetics , Diabetes Mellitus, Type 1/genetics , Polymorphism, Genetic , Autoimmunity , Case-Control Studies , Chile , Diabetes Mellitus, Type 1/immunology , Haplotypes
8.
J. bras. pneumol ; 41(1): 31-38, Jan-Feb/2015. tab, graf
Article in English | LILACS | ID: lil-741565

ABSTRACT

Objective: To determine whether the use of a set of preoperative variables can predict the need for postoperative ICU admission. Methods: This was a prospective observational cohort study of 120 patients undergoing elective pulmonary resection between July of 2009 and April of 2012. Prediction of ICU admission was based on the presence of one or more of the following preoperative characteristics: predicted pneumonectomy; severe/very severe COPD; severe restrictive lung disease; FEV1 or DLCO predicted to be < 40% postoperatively; SpO2 on room air at rest < 90%; need for cardiac monitoring as a precautionary measure; or American Society of Anesthesiologists physical status ≥ 3. The gold standard for mandatory admission to the ICU was based on the presence of one or more of the following postoperative characteristics: maintenance of mechanical ventilation or reintubation; acute respiratory failure or need for noninvasive ventilation; hemodynamic instability or shock; intraoperative or immediate postoperative complications (clinical or surgical); or a recommendation by the anesthesiologist or surgeon to continue treatment in the ICU. Results: Among the 120 patients evaluated, 24 (20.0%) were predicted to require ICU admission, and ICU admission was considered mandatory in 16 (66.6%) of those 24. In contrast, among the 96 patients for whom ICU admission was not predicted, it was required in 14 (14.5%). The use of the criteria for predicting ICU admission showed good accuracy (81.6%), sensitivity of 53.3%, specificity of 91%, positive predictive value of 66.6%, and negative predictive value of 85.4%. Conclusions: The use of preoperative criteria for predicting the need for ICU admission after elective pulmonary resection is feasible and can reduce the number of patients staying in the ICU only for monitoring. .


Objetivo: Avaliar se a utilização de um conjunto de variáveis pré-operatórias é capaz de antever a necessidade de internação em UTI no pós-operatório. Métodos: Estudo de coorte observacional prospectivo, com 120 pacientes submetidos à ressecção pulmonar eletiva entre julho de 2009 e abril de 2012. A previsão de indicação de internação em UTI indicação foi baseada na presença de uma ou mais das seguintes condições pré-operatórias: previsão de pneumonectomia; DPOC grave/muito grave; doença restritiva grave; VEF1 ou DLCO previstos para o pós-operatório < 40% do previsto; SpO2 em repouso e ar ambiente < 90%; necessidade de monitorização cardíaca profilática; classificação da American Society of Anesthesiologists ≥ 3. O padrão ouro para internação justificada em UTI foi baseado na presença de uma ou mais das seguintes condições pós-operatórias: manutenção de ventilação mecânica ou reintubação; insuficiência respiratória aguda ou necessidade de ventilação não invasiva; instabilidade hemodinâmica ou choque; intercorrências intraoperatórias ou no pós-operatório imediato (cirúrgicas ou clínicas); indicação do anestesiologista ou cirurgião para a manutenção de tratamento na UTI. Resultados: Dos 120 pacientes avaliados, houve previsão de necessidade de internação em UTI em 24 (20,0%), sendo essa considerada justificada em 16 deles (66,6%) desses 24, ao passo que dos 96 pacientes sem previsão de necessidade de internação em UTI, essa foi necessária em 14 (14,5%). A utilização dos critérios preditivos para a internação em UTI mostrou boa acurácia (81,6%), sensibilidade de 53,3%, especificidade de 91%, valor preditivo positivo de 66,6% e valor preditivo negativo de 85,4%. Conclusões: A utilização de critérios pré-operatórios para a indicação de internação em UTI após ressecção pulmonar eletiva é factível e é capaz de reduzir o número de pacientes que aí permanecem apenas para vigilância. .


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Autoantibodies/blood , Diabetes Mellitus, Type 1/diagnosis , /diagnosis , Glutamate Decarboxylase/immunology , Age of Onset , Anticholesteremic Agents/therapeutic use , Double-Blind Method , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/immunology , /drug therapy , /immunology , Glucose Intolerance , Germany/epidemiology , Heptanoic Acids/therapeutic use , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Metabolic Syndrome/diagnosis , Metabolic Syndrome/drug therapy , Phenotype , Prevalence , Prospective Studies , Pyrroles/therapeutic use , Risk Factors
9.
Arch. endocrinol. metab. (Online) ; 59(1): 4-12, 02/2015. tab, graf
Article in English | LILACS | ID: lil-746453

ABSTRACT

Type 1 diabetes mellitus (T1DM) is a chronic, progressive autoimmune disease characterized by metabolic decompensation often leading to dehydration and ketoacidosis. Viral agents seem to play an important role in triggering the autoimmune destruction that leads to the development of T1DM. Among several viral strains investigated so far, the enterovirus family has been consistently associated with the onset of T1DM in humans. One of the mediators of viral damage is the double-stranded RNA (dsRNA) generated during replication and transcription of viral RNA and DNA. The Toll-like receptor 3 (TLR3) gene codes for an endoplasmic receptor of the pattern-recognition receptors (PRRs) family that recognizes dsRNA, plays an important role in the innate immune response triggered by viral infection. Binding of dsRNA to the TLR3 triggers the release of proinflammatory cytokines, such as interferons, which exhibit potent antiviral action; thus, protecting uninfected cells and inducing apoptosis of infected ones. Therefore, the TLR3 gene is a good candidate for the development of T1DM. Within this context, the objective of the present review was to address the role of the TLR3 gene in the development of T1DM. Arch Endocrinol Metab. 2015;59(1):4-12.


Subject(s)
Animals , Humans , Diabetes Mellitus, Type 1/genetics , RNA, Double-Stranded/metabolism , /genetics , Cytokines/metabolism , Diabetes Mellitus, Type 1/immunology , Diabetes Mellitus, Type 1/virology , Enterovirus/immunology , Enterovirus/physiology , Immunity, Innate/physiology , Inflammation/metabolism , Insulin-Secreting Cells/metabolism , Signal Transduction/physiology , /metabolism , Virus Replication/genetics , Virus Replication/immunology
10.
Arq. bras. endocrinol. metab ; 58(7): 737-743, 10/2014. tab, graf
Article in English | LILACS | ID: lil-726253

ABSTRACT

Objective Zinc transporter 8 autoantibodies (ZnT8A) have been poorly studied in non-Caucasian individuals. We aimed to investigate the prevalence of ZnT8 autoantibodies in patients with T1D and their first degree relatives (FDR) from a multiethnic population, as well as its relation with the insulin (INS) or the protein tyrosine phosphatase non-receptor 22 (PTPN22) gene polymorphisms. Subjects and methods ZnT8A were analyzed in sera from T1D patients (n = 72, mean age of 30.3 ± 11.4 years) of variable duration (15.7 ± 11.8 years) and their FDR (n = 78, mean age of 18.3 ± 9.1 years) by a triple mix Radioligand Binding Assay (RBA) for the ZnT8 autoantibody (ZnT8-RWQ) variants. SNP (single nucleotide polymorphism) for INS and PTPN22 were genotyped. Results The prevalence of ZnT8A was higher in T1D patients than FDR, for ZnT8TripleA (24% vs. 4%,p = 0.001), ZnT8RA (24% vs. 4%, p < 0.001) and ZnT8QA (15% vs. 3%, p = 0.004). All FDR with ZnT8A (n = 3) had at least another positive antibody. Heterozygosis for PTPN22 was associated with a higher frequency of ZnT8TripleA (p = 0.039) and ZnT8RA (p = 0.038). Conclusions ZnT8A is observed in non-Caucasian patients with T1D, even years after the disease onset, as well as in their FDR. In those, there was an overlap between ZnT8A and other T1D antibodies. ZnT8A was associated with PTPN22 polymorphisms. Further longitudinal studies are necessary to elucidate the importance of these findings in the natural history of T1D patients with multiethnic background. .


Objetivo Os autoanticorpos transportadores de zinco 8 (ZnT8A) foram pouco estudados em indivíduos não caucasianos. Nosso objetivo foi investigar a prevalência de autoanticorpos ZnT8 em pacientes com T1D e seus parentes de primeiro grau (PPG) em uma população multiétnica, assim como a sua relação com os polimorfismos genéticos da insulina (INS) ou proteína tirosina fosfatase não receptora tipo 22 (PTPN22). Sujeitos e métodos ZnT8A foram analisados no soro de pacientes com T1D (n = 72, idade média de 30,3 ± 11,4 anos) de duração variável (15,7 ± 11,8 anos) e seus PPG (n = 72, idade média de 30,3 ± 11,4 anos) usando-se um ensaio de competição com radioligantes (RBA) para variantes dos autoanticorpos ZnT8 (ZnT8-RWQ). Os polimorfismos de nucleotídeo único para a INS e PTPN22 foram genotipados. Resultados A prevalência de ZnT8A foi mais alta em pacientes T1D do que nos PPG, para ZnT8TriploA (24% contra 4%, p = 0,001), ZnT8RA (24% contra 4%, p < 0,001) e ZnT8QA (15% contra 3%, p = 0,004). Todos os PPG com ZnT8A (n = 3) apresentaram positividade para pelo menos outro anticorpo. A heterozigose para PTPN22 foi associada a uma frequência mais alta de ZnT8TriploA (p = 0,039) e de ZnT8RA (p = 0,038). Conclusões Os ZnT8A foram observados em pacientes não caucasianos com T1D, mesmo depois de anos do início da doença, assim como em seus PPG. Nos parentes, houve uma sobreposição entre os ZnT8A e outros anticorpos para T1D. Os ZnT8A mostraram-se associados aos polimorfismos PTPN22. São necessários outros estudos longitudinais para se elucidar a importância desses achados na história natural de pacientes com T1D com antecedentes étnicos variados. .


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Autoantibodies/immunology , Cation Transport Proteins/immunology , Diabetes Mellitus, Type 1/immunology , Family/ethnology , Autoantibodies/genetics , Brazil/epidemiology , Brazil/ethnology , Cation Transport Proteins/blood , Cation Transport Proteins/genetics , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/ethnology , Diabetes Mellitus, Type 1/genetics , Genotype , Insulin/genetics , Prevalence , Polymorphism, Genetic/genetics , /genetics , Radioligand Assay
11.
Rev. chil. endocrinol. diabetes ; 7(1): 6-9, ene.2014. tab
Article in Spanish | LILACS | ID: lil-779326

ABSTRACT

To determine the serological levels of inflammatory markers and autoimmunity in patients with T1D compared with controls, and determined its relation to the duration of diabetes. Methods: We selected 139 patients with T1D without chronic complications of diabetes, and 110 control subjects without family history of diabetes. Serological ultrasensitive C-reactive protein levels (usCRP), interleukin- 6 and adhesion protein VCAM through ELISA assay were determined. Autoimmune profile was also analyzed through GAD65, IA-2 and ZnT8 autoantibodies. Results: Increased levels of usCRP 1.74 (0.10 to 13.6) vs 1.08 (0.40 to 3.70) ng/ml (p < 0.03), VCAM 236.0 (122.2 to 693.5) vs 185.4 (101.3 to 421.3) ng/ml, p < 0.02 and IL-6 1.73 (0.40 to 9.10) vs 1.28 (0.30 to 4.60) ng/ml, p < 0.05 was found in the group of T1D patients compared with the control group. When analyzing inflammatory markers according to age groups (0-10 years and > 10 years), the values of usCRP were higher in the second group. There was no significant association between patients with DM1 and autoimmune positive profile with a higher frequency of markers of inflammation. Conclusions: These results suggest the presence of pro-inflammatory state is considerably more frequent in patients with T1D. The increased level of usCRP and IL -6 and according to age of the patients could indicate a possible role of adiposity and weight gain during the adolescence in the higher frequency of inflammatory markers in T1D patients...


Subject(s)
Humans , Male , Adolescent , Female , Child, Preschool , Child , Diabetes Mellitus, Type 1/immunology , Glutamate Decarboxylase/immunology , /immunology , C-Reactive Protein/immunology , Autoimmunity , Autoantibodies/analysis , Biomarkers , Glutamate Decarboxylase/analysis , Immunoenzyme Techniques , Inflammation , /analysis , C-Reactive Protein/analysis
12.
J. pediatr. (Rio J.) ; 90(1): 7-15, jan-feb/2014. tab
Article in English | LILACS | ID: lil-703624

ABSTRACT

OBJECTIVE: The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. SOURCES: Non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes). DATA SYNTHESIS: The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. CONCLUSION: Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes. .


OBJETIVO: Realizar uma análise crítica da literatura para avaliar a influência da amamentação no risco de desenvolvimento de diabetes mellitus. FONTE DOS DADOS: Revisão não sistemática nas bases de dados SciELO, LILACS, MEDLINE, Scopuse BVS, selecionando-se 52 referências mais relevantes. Especificamente sobre o tema, foram analisadas 21 (sendo 9 para diabetes tipo 1 e 12 para diabetes tipo 2). SÍNTESE DOS DADOS: A duração, a exclusividade do aleitamento materno e uso precoce do leite de vaca têm sido apresentados como fatores de risco para o desenvolvimento de diabetes. Acredita-se que o leite humano contenha substâncias que promovem a maturação do sistema imunológico protegendo contra o diabetes tipo 1. Além disso, ele possui substâncias bioativas, que promovem o equilíbrio energético e a saciedade, prevenindo o ganho de peso excessivo da criança e protegendo, consequentemente, contra o aparecimento do diabetes tipo 2. Apesar dos benefícios anteriormente citados não terem sido constatados por alguns pesquisadores, a imprecisão no relato dos hábitos dietéticos da infância e a presença de fatores interferentes têm sido responsabilizadas pela falta de identificação dos efeitos benéficos. CONCLUSÃO: Diante das evidências científicas pautadas em grande parte dos estudos, acredita-se que a ausência da amamentação seja um possível fator de risco modificável para diabetes tipo 1 e tipo 2. Estratégias que visem à promoção e ao suporte ao aleitamento materno devem ser adotadas por profissionais de saúde devidamente treinados como forma de prevenir a manifestação da doença. .


Subject(s)
Animals , Cattle , Child , Female , Humans , Breast Feeding , Diabetes Mellitus, Type 1/immunology , /immunology , Milk, Human/immunology , Diabetes Mellitus, Type 1/etiology , Diabetes Mellitus, Type 1/prevention & control , /etiology , /prevention & control , Milk/adverse effects , Milk/immunology , Overweight/prevention & control , Risk Factors , Time Factors
13.
Article in English | WPRIM | ID: wpr-208230

ABSTRACT

The importance of innate immunity in host defense is becoming clear after discovery of innate immune receptors such as Toll-like receptor or Nod-like receptor. Innate immune system plays an important role in diverse pathological situations such as autoimmune diseases. Role of innate immunity in the pathogenesis of metabolic disorders such as type 2 diabetes, metabolic syndrome or atherosclerosis that has not been previously considered as inflammatory disorders, is also being appreciated. Here, the role of innate immunity in the development of type 1 diabetes, a classical organ-specific autoimmune disease, and type 2 diabetes will be discussed, focusing on the role of specific innate immune receptors involved in these disease processes.


Subject(s)
Animals , Cytokines/immunology , Diabetes Mellitus, Type 1/immunology , Diabetes Mellitus, Type 2/immunology , Humans , Immunity, Innate/immunology , Inflammasomes/immunology , Models, Immunological , Pancreas/immunology
14.
Egyptian Journal of Medical Human Genetics [The]. 2014; 15 (1): 25-30
in English | IMEMR | ID: emr-154344

ABSTRACT

Type 1 diabetes is one of the most common chronic childhood illnesses. Interplay between genetic susceptibility and environmental factors is thought to provide the fundamental element for the disease. Apart from the Major Histocompatibility locus which is the main contributor to risk susceptibility, more than 40 loci are recognized. One among these is the CTLA-4, however data from the literature are controversial. The aim of our study was to investigate the role of CTLA4 49 A/G as a risk susceptibility factor for the development of type 1 diabetes in a cohort of Egyptian families. This is a case control study including 88 Egyptian families with one or more index cases [< 18 years]. The control group comprised 369 healthy unrelated subjects with no family history of diabetes or autoimmune disease. Using PCR-RFLP methodology, CTLA4 49 A/G was analyzed in 738 samples representing 88 families [88 patients, 125 siblings and 156 parents] and 369 control. The age of onset was 6 days-12.5 years with a mean of 5.3 +/- 3.6 and a median of 5 years. The mode of presentation was classic symptoms in 51 and diabetic ketoacidosis in 37 cases. Twenty-two cases had a history of viral infection or exanthematous disease and four had associated autoimmune diseases. No significant differences were encountered between the different groups with regard to CTLA4 +49 A/G genotype or allele frequencies. Neither was there a relation between the various genotypes and age of onset or the mode of presentation. CTLA4 49 A/G polymorphism was not recognized as a risk susceptibility factor in our cohort. This may be attributed to the low co-incidence of autoimmune diseases. Up to our best knowledge, this is the first study involving families. We recommend that all studies performed on risk susceptibility to type 1 diabetes should include proper investigation for other autoimmune diseases to exclude their confounding effect on data analysis


Subject(s)
Humans , Male , Female , Polymorphism, Genetic , Risk Factors , Diabetes Mellitus, Type 1/immunology , Polymerase Chain Reaction/methods
15.
Arq. bras. endocrinol. metab ; 57(9): 667-676, Dec. 2013. ilus, graf, tab
Article in English | LILACS | ID: lil-696911

ABSTRACT

Type 1 diabetes mellitus (T1DM) is a chronic, progressive, autoimmune disease characterized by metabolic decompensation frequently leading to dehydration and ketoacidosis. Viral pathogens seem to play a major role in triggering the autoimmune destruction that leads to the development of T1DM. Among several viral strains investigated so far, enteroviruses have been consistently associated with T1DM in humans. One of the mediators of viral damage is the double-stranded RNA (dsRNA) generated during replication and transcription of viral RNA and DNA. The IFIH1 gene encodes a cytoplasmic receptor of the pattern-recognition receptors (PRRs) family that recognizes dsRNA, playing a role in the innate immune response triggered by viral infection. Binding of dsRNA to this PRR triggers the release of proinflammatory cytokines, such as interferons (IFNs), which exhibit potent antiviral activity, protecting uninfected cells and inducing apoptosis of infected cells. The IFIH1 gene appears to play a major role in the development of some autoimmune diseases, and it is, therefore, a candidate gene for T1DM. Within this context, the objective of the present review was to address the role of IFIH1 in the development of T1DM.


O diabetes melito tipo 1 (T1DM) é uma doença autoimune crônica e progressiva caracterizada por descompensações metabólicas frequentemente acompanhadas por desidratação e cetoacidose. Os agentes virais parecem ter um papel importante no desencadeamento da destruição autoimune que leva ao desenvolvimento do T1DM. Entre as cepas virais estudadas até agora, a família dos enterovírus foi consistentemente associada ao surgimento da doença em humanos. Um dos mediadores do dano viral é o RNA fita dupla (RNAfd) gerado durante a replicação e transcrição de RNA e DNA viral. O gene IFIH1 codifica um receptor citoplasmático pertencente à família dos pattern-recognition receptors (PRRs) que reconhece o RNAfd, tendo um papel importante na resposta imune inata desencadeada por infecção viral. A ligação do RNAfd a essa PRR desencadeia a liberação de citocinas pró-inflamatórias como interferons (IFNs), os quais exibem uma potente ação antiviral e têm como objetivo proteger as células não infectadas e induzir apoptose naquelas já contaminadas. O gene IFIH1 parece ter uma participação importante no desenvolvimento de algumas doenças autoimunes. Por isso, esse gene é um candidato ao desenvolvimento do T1DM. Dentro desse contexto, o objetivo da presente revisão foi abordar o papel do IFIH1 no desenvolvimento do T1DM.


Subject(s)
Humans , DEAD-box RNA Helicases/physiology , Diabetes Mellitus, Type 1/genetics , Immunity, Innate/genetics , DEAD-box RNA Helicases/immunology , Diabetes Mellitus, Type 1/immunology , Diabetes Mellitus, Type 1/virology , Genetic Predisposition to Disease , Polymorphism, Genetic , Risk Factors
16.
Arq. bras. endocrinol. metab ; 57(9): 733-738, Dec. 2013. graf
Article in Portuguese | LILACS | ID: lil-696920

ABSTRACT

OBJETIVO: Caracterizar uma população de pacientes com diabetes melito tipo 1 (DMT1) relativamente à presença de outras entidades autoimunes que permitam estabelecer o diagnóstico de síndrome poliglandular autoimune (SPGA). SUJEITOS E MÉTODOS: Incluímos 151 pacientes com DMT1. Analisamos os seguintes parâmetros clínicos: gênero, idade atual, duração da doença, antecedentes pessoais de patologia autoimune e antecedentes familiares de diabetes melito. Submetemos cada doente a um estudo laboratorial com o objetivo de detectar a presença de marcadores imunológicos para a tireoidite, insuficiência adrenocortical, gastrite e doença celíaca, e eventual disfunção associada. RESULTADOS: Coorte com 51,7% homens, idade média atual de 33,4 ± 13 anos e duração da doença de 14,4 ± 9,6 anos. Antecedentes pessoais de autoimunidade presentes em 2% da amostra e história familiar de diabetes melito em 31,1%. A frequência de marcadores imunológicos foi de 24% para a tireoidite, 9,4% para a insuficiência adrenocortical, 17,2% para a gastrite e 2% para a doença celíaca. Foi diagnosticada SPGA em 25,2% dos pacientes. O risco de SPGA e tireoidite autoimune foi superior em mulheres. A duração da doença correlacionou-se diretamente com a presença de autoanticorpos gástricos e inversamente com a positividade dos anticorpos anti-ilhota, antiglutamato descarboxilase e antitirosina fosfatase. Constatou-se a existência de uma associação entre os marcadores imunológicos da tireoidite e gastrite, bem como entre a doença celíaca e insuficiência adrenocortical. CONCLUSÃO: Atendendo à frequência e ao prognóstico inerente à SPGA, a necessidade de realizar rastreio em pacientes com DMT1 é enfatizada. O diagnóstico atempado de outras doenças autoimunes permitirá individualizar o tratamento e seguimento do doente.


OBJECTIVE: To characterize a cohort of patients with type 1 diabetes mellitus (T1DM) on the presence of other autoimmune disorders that could establish the diagnosis of autoimmune polyglandular syndrome (APS). SUBJECTS AND METHODS: We included 151 patients with T1DM. The following clinical parameters were analyzed: gender, current age, disease duration, previous history of autoimmune disorders, and familial history for diabetes mellitus. Each patient was analyzed to detect autoimmune markers of thyroiditis, adrenocortical insufficiency, gastritis, and celiac disease, as well as possible associated dysfunctions. RESULTS: A cohort with 51.7% males, average current age of 33.4 ± 13 years and disease duration of 14.4 ± 9.6 years was analyzed. Previous history of autoimmunity was found in 2%, and familial history for diabetes mellitus in 31.1% of the cohort. Frequency of autoimmune markers was 24% for thyroiditis, 9.4% for adrenocortical insufficiency, 17.2% for gastritis, and 2% for celiac disease. APS was diagnosed on 25.2% of the patients. APS and autoimmune thyroiditis risk was higher in females. Disease duration correlated directly with gastric autoantibodies, and inversely with positive islet cell, glutamic acid decarboxylase, and tyrosine phosphatase antibodies. We noticed a correlation between autoimmune markers for thyroiditis and gastritis, as well as between celiac disease and adrenocortical insufficiency. CONCLUSION: Considering APS prevalence and prognosis, the need for APS screening in patients with T1DM is emphasized. Early diagnosis of other autoimmune disorders will enable us to adjust each patient treatment and follow-up.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Diabetes Mellitus, Type 1/immunology , Polyendocrinopathies, Autoimmune/diagnosis , Addison Disease/immunology , Anemia/immunology , Autoantibodies/analysis , Biomarkers/analysis , Celiac Disease/immunology , Diabetes Mellitus, Type 1/complications , Early Diagnosis , Gastritis/immunology , Iron/deficiency , Mass Screening , Polyendocrinopathies, Autoimmune/complications , Polyendocrinopathies, Autoimmune/immunology , Thyroiditis, Autoimmune/immunology , Thyroiditis/immunology , /immunology
17.
Rev. chil. endocrinol. diabetes ; 6(2): 55-58, abr. 2013. tab
Article in Spanish | LILACS | ID: lil-726575

ABSTRACT

Background: The programmed cell death 1 (PDCD-1) immune-receptor is a key element in the negative regulation of peripheral tolerance in T cells. The gene has several polymorphisms and can be associated with susceptibility to autoimmune diseases. Aim: To analyze the frequency and distribution of PD-1.3 polymorphism of PDCD-1 gene and explore its possible contribution as a susceptibility gene for type 1 diabetes (T1D). Patients and Methods: We analyzed 248 cases with T1D with recent diagnosis and 160 control children under 15 years of Santiago. Genetic polymorphism in PD-1 gene variant for PD-1.3 (rs 11568821) was analyzed by polymerase chain reaction and restriction fragment length polymorphism. Comparison of genotype, allele frequency and consistency with respect to Hardy-Weinberg were analyzed using X2 tests and Fisher exact test. Results: There was a very low frequency of the genotype A/A, both in T1D patients and in controls (< 2 percent). The A/G genotype was more common in diabetic patients than in controls (41.6 and 18.8 percent respectively, p < 0.04). G/G genotype was more common in controls than in patients (79.4 and 56.8 percent respectively, p < 0.02). T1D patients carrying genotype G/G had a higher frequency of anti-GAD65 and anti-A-2 antibodies (81 and 67 percent respectively). Conclusions: The distribution of PD-1.3 genotype frequencies are similar to that reported elsewhere. Possibly, this genetic variant (rs 11568821) does not have an important marker role in Chilean T1D patients.


Subject(s)
Humans , Adolescent , Child , Diabetes Mellitus, Type 1/genetics , Polymorphism, Genetic , Programmed Cell Death 1 Receptor/genetics , Autoimmunity , Antibodies/analysis , Diabetes Mellitus, Type 1/immunology , Gene Frequency , Genetic Markers , Genotype
18.
IPMJ-Iraqi Postgraduate Medical Journal. 2013; 12 (3): 351-358
in English | IMEMR | ID: emr-142897

ABSTRACT

Type 1 diabetes is characterized by a complete or near-complete insulin deficiency caused by an immune-mediated selective destruction of the insulin-producing beta-cells in the Islets of Langerhans. Inflammatory mechanisms play a key role in the pathogenesis of type 1 diabetes. Many findings suggest that the Islet autoantibody status in type 1 diabetes is linked to disease activity. To investigate the hypothesis that the systemic immunoregulatory balance, as defined by levels of circulating cytokines, is associated with Islet autoantibody status. Cytokines [IL-2, IL-4, IL-5, IL-10, TNF-beta and INF-gamma] and Islet autoantibodies [ICA, GADA, IA-2] were measured in 56 patients with insulin dependent diabetes mellitus [IDDM] and 20 healthy control patients. The three proinflammatory cytokines measured [interleukin-2 [IL-2], interferon gamma [IFN-gamma] and tumor necrosis factor-beta [TNF-beta]], both TNF-beta [50.0 +/- 5.9] [63.4 +/- 5.4] and INF-gamma [13.8 +/- 10.9] [13.7 +/- 5.5] showed a significant increase [P <0.05] with Islet autoantibody positivity, while the other three cytokines, [IL-4, IL-5 and IL-10], only IL-4 showed a positive increase [54.4 +/- 1.4] with Islet autoantibody positivity although it is non- significant association. The study reveals the possibility of the of Islet autoantibodies in the domination of proinflammatory cytokines over the immunoregulatory cytokines


Subject(s)
Humans , Male , Female , Cytokines/blood , Diabetes Mellitus, Type 1/immunology , Interleukins/blood
19.
Rev. méd. Chile ; 140(11): 1476-1481, nov. 2012. ilus
Article in Spanish | LILACS | ID: lil-674016

ABSTRACT

Backgroud: Latent Autoimmune Diabetes in Adults (LADA) is the term used to describe adults who have a slowly progressive form of diabetes mellitus (DM) of autoimmune etiology, but that may be treated initially without insulin. Although it shares some immunological and genetic aspects with type 1 DM, it affects an age group that is typically affected by type 2 DM. Therefore, it could be considered an intermediate type. Diagnosis is based on clinical and laboratory criteria: age of onset, initial response to oral hypoglycemic agents and the presence of specific antibodies for diabetes. Although the definitive treatment is insulin, glitazones may be useful in early stages of the disease. Currently, its management represents a challenge for the physician, including specialists, and it is a form of DM to keep in mind.


Subject(s)
Adult , Humans , Diabetes Mellitus/immunology , Age Factors , Algorithms , Diagnosis, Differential , Disease Progression , Diabetes Complications/diagnosis , Diabetes Mellitus, Type 1/genetics , Diabetes Mellitus, Type 1/immunology , /immunology , Diabetes Mellitus/genetics , Diabetes Mellitus/therapy , Insulin/therapeutic use
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