mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-2005-1-41-48mimmun-418Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESВЗАИМОСВЯЗЬ АНТИТЕЛ К КЛЕТКАМ ОСТРОВКОВ ЛАНГЕРГАНСА С ОСТАТОЧНОЙ ФУНКЦИЕЙ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ У БОЛЬНЫХ С САХАРНЫМ ДИАБЕТОМ 1 ТИПАRELATION OF ISLET CELLS ANTIBODIES AND RESIDUAL FUNCTION OF PANCREAS IN PATIENTS WITH DIABETES TYPE IТихомироваТ. А.TihomirovaT. A.

197089, Санкт–Петербург, ул.Льва Толстого, д. 6/8

tihomirovata@yandex.ruЛапинС. В.LapinS. V.tihomirovata@yandex.ruТолкачеваН. Ф.TolkachevaN. F.tihomirovata@yandex.ruТотолянАрег А.TotolianAreg A.tihomirovata@yandex.ruНМЦ МЗиСР по молекулярной медицине на базе СПбГМУ им. акад. И.П.ПавловаRussian FederationДетская городская больница им. К.А. Раухфуса № 19, Санкт–ПетербургRussian Federation200521072014714148Copyright © Тихомирова Т.А., Лапин С.В., Толкачева Н.Ф., Тотолян А.А., 20142014Тихомирова Т.А., Лапин С.В., Толкачева Н.Ф., Тотолян А.А.Tihomirova T.A., Lapin S.V., Tolkacheva N.F., Totolian A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/418

Резюме. Антитела к островковым клеткам поджелудочной железы (ICA) являются чувствительным и высокоспецифичным серологическим маркером сахарного диабета тип 1 (СД1).

С помощью метода непрямой иммунофлуоресценции мы исследовали сыворотку 50 детей (до 16 лет) с СД1 и 46 взрослых с СД1. В качестве контроля использовали сыворотку 10 детей и 40 взрослых.

В качестве субстрата использовались криосрезы человеческой поджелудочной железы (5 мкм). Сыворотка пациента инкубировалась с субстратом в течение 30 минут и несвязавшиеся сывороточные белки отмывались в фосфатно–солевом буфере (0,01М, рН 7,2). Для выявления связавшихся с тканью аутоантител использовалась антисыворотка против иммуноглобулинов человека. С помощью люминесцентного микроскопа оценивалось наличие специфического свечения цитоплазмы островковых клеток.

Специфичность метода составила 100%. У детей и взрослых в дебюте заболевания ICA встречались чаще по сравнению с больными с текущим СД1: 75,6 % и 21,8 % соответственно (p <0,05). Мы обнаружили, что ICA–серопозитивные пациенты нуждаются в меньшей дозе инсулина для коррекции углеводного обмена вне зависимости от длительности СД1, чем серонегативные пациенты: 0,056±0,04 единицы инсулина на кг веса тела в день в детях против 0,747 ±0,08 (p <0,05) и 34,8 ±2,3 против 50,42±2,55 единицы инсулина в день во взрослых, соответственно.

Лабораторные характеристики метода позволяют использовать его для подтверждения диагноза СД1 у детей. Кроме того, нам представляется вероятным, что наличие у больного сахарным диабетом ICA косвенно свидетельствует о наличии остаточной функции островковых клеток.

Abstract. Islet cells antibodies of a pancreas (ICA) are the sensitive and high–specific serological marker of diabetes type I (IDDM). Serum of 50 children (less than 16 yr.old) and 46 adult patients with IDDM was tested for ICA with indirect immunofluorescence. The control group consisted of 10 children and 40 adults without endocrinologic disorders.

Serial cryosections of human pancreas 5 mkm thick were incubated with patients serum for 30 min. After the unbound serum proteins were washed away with phosphate buffered saline (0.01M, pH 7.2) the section was incubated with FITC labeled antiserum against human immunoglobulins. Specific cytoplasmic fluorescence of islet cells was scored as positive test result.

No specific staining was found in serum of the control group and specificity of the method was 100%. In adults and children at onset of IDDM ICA were found statistically more frequently than in patients with longstanding disease: 75,6 % v.s. 21,8 % (p <0,05). All ICA–seropositive patients require significantly smaller doseof insulin than seronegative patients independently of disease duration. In children ICA–seropositive patients require 0,056±0,04 U per kg of body weight per day v.s. 0,747±0,08 U/kg/day (p<0,05) in seronegative patients. In adults seropositive patients used 34,8±2,3 U/day v.s. 50,42±2,55 U/day in seronegative patients.

Immunofluorescent test for ICA detection could be used in children with recent onset of the disease for confirmation of IDDM. Also, ICA in a patient with IDDM could indirectly indicate the presence of residual function of islet cells. (Med. Immunol., 2005, vol.7, № 1, pp. 41548)

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The authors declare that there are no conflicts of interest present.