ABSTRACT
To evaluate glutamic acid decarboxylase autoantibodies (GAD65), islet cell autoantibodies (ICA) and insulin autoantibodies (IAA) as disease markers and their relationship to certain residual beta-cell function as well as glycemic control among patients with diabetes mellitus. Also, to evaluate of the level of CD4+CD25+(Treg) out of CD4 cells among patients with immune mediated diabetes mellitus (DM). The study included 80 individuals divided into: 40 diabetic patients (group A) and 20 risk siblings (group B) of diabetic father or mother or both. 20 healthy individuals enrolled as control group (group C) all were with no family history of DM. GAD, ICA, IAA autoantibodies and C-peptide were determined by ELISA. HbA1 by ion exchange chromatography and measurement of the expression of CD4+CD25+ (T reg) by flowcytometry. The most frequently encountered antibody in adult and children groups was GAD65, followed by ICA. But in risk group the most frequently antibody was ICA, followed by GAD. In the risk group, there was no statistical difference in the level of CD4+CD25+ in comparison with control group. There was significant decrease in the percentage of CD4+CD25+ in adult and children patients groups with positive autoantibodies than those with negative autoantibodies. In conclusions, at the time of diagnosis the majority of patients with type I diabetes have autoantibodies that are reactive to islet antigens. GAD, ICA, IAA are of value for predicting IDDM in sibling of diabetic parents type I. CD4+CD25+ Treg cells may actively suppress activation of the immune system and prevent pathological self-reactivity.
Subject(s)
Autoantibodies/blood , Biomarkers/blood , Diabetes Mellitus/immunology , Islets of Langerhans/immunology , Adolescent , Adult , Autoantibodies/analysis , Autoantigens/immunology , Diabetes Mellitus/blood , Diabetes Mellitus/diagnosis , Female , Flow Cytometry , Glutamate Decarboxylase/immunology , Humans , Insulin/immunology , Insulin Antibodies/analysis , Insulin Antibodies/blood , Male , Middle Aged , T-Lymphocytes, Regulatory/immunology , Young AdultABSTRACT
BACKGROUND: Postpartum thyroid dysfunction (PPTD) occurs in the first 12 months after delivery. This work was designed to compare thyroid peroxidase (TPO) and thyroglobulin (Tg) autoantibodies for determination of the diagnosis and, also, to detect role of lymphocytes in the pathogenesis of autoimmune thyroiditis. METHODS: This study was conducted on 50 females in postpartum period. Thyroid hormones, TPO- and Tg-Abs, and percentages of blood lymphocytes were determined. RESULTS: The TPO-Abs were positive in 1(4%),10 (66.7%),6 (60%) of the control, hyperfunction, and hypofunction groups, respectively. The Tg-Abs were positive in 1(4%), 8 (533%), 5 (50%) of same groups, respectively. There was significant negative correlation between serum FT4 and TPO and Tg antibody titers in the hypofunction group. In cases with positive TPO-Abs, there were significantly decreased natural killer cells (NK) and significantly increased activated T cells when compared to the control group and to the TPO negative cases. CONCLUSIONS: The TPO Ab was more sensitive than Tg Ab in predicting PPTD and a high titer of both correlates with the severity of hypothyroidism. Two forms of PPTD appeared to exist: autoimmune form characterized by positive TPO-Ab and increased activated T cells and reduced NK cells and a non immune form without these characteristics.
