GAD65反应性T细胞检测在成人隐匿性自身免疫糖尿病筛查中的应用研究

发布时间：2018-06-17 04:30

本文选题：糖尿病 + 自身免疫　；参考：《中国实用内科杂志》2017年07期

【摘要】：目的探讨酶联免疫斑点试验(ELISPOT)检测谷氨酸脱羧酶反应性分泌IFN-γT细胞(GAD65-T)在成人隐匿性自身免疫糖尿病(LADA)筛查中的应用。方法选择2014年至2016年福建医科大学附属泉州第一医院收治的LADA患者28例,2型糖尿病(T2DM)40例,健康对照20例,放射配体法检测GAD65-Ab,连续密度梯度离心法分离人外周血单个核细胞(PBMC),ELISPOT法检测GAD65-T细胞。将40例T2DM分为GAD65-T细胞ELISPOT检测阳性及阴性组,比较两组的临床特征。结果 GAD65-T细胞数(中位数及95%CI)LADA组为7.2(1.9~11.1)个,T2DM组为3.6(2.9~6.0)个,对照组为0.9(0.2~1.7)个。LADA组的细胞数明显高于T2DM及对照组(P均0.01);T2DM较对照组具有更高频率的细胞数(P0.05)。以大于95%CI(对照组)判为阳性,LADA,T2DM及对照组的阳性率分别为71.4%(20/28)、32.5%(13/40)、0。40例T2DM亚组分析显示GAD65-T细胞ELISPOT检测阳性组较阴性组的患者BMI更低、血糖控制更差、空腹C肽水平更低。结论部分GAD65-Ab阴性的T2DM患者存在GAD65-T细胞,联合GAD65-T细胞ELISPOT及GAD65-Ab检测可明显提高LADA的检出率。
[Abstract]:Objective to investigate the application of enzyme-linked immunoblot assay (ELISPOT) in the screening of latent autoimmune diabetes mellitus (AIDDM) in adults by detecting the reactivity of glutamate decarboxylase secreting IFN- 纬 T cells (GAD65-T). Methods A total of 28 Lada patients with type 2 diabetes mellitus and 20 healthy controls were selected from 2014 to 2016 in Quanzhou first Hospital of Fujian Medical University. Human peripheral blood mononuclear cells were isolated by continuous density gradient centrifugation and GAD65-T cells were detected by radioligand assay and ELISPOT method. Forty cases of T2DM were divided into positive and negative groups of GAD65-T cells detected by Elispot. The clinical features of the two groups were compared. Results the number of GAD65-T cells in the GAD65-T group (median and 95% CILADA) was 7.2n9 / 11.1) and the number of cells in the T2DM group was 3.6n2.9c6.0) and in the control group was 0.90.21.7. the number of cells in Lada group was significantly higher than that in T2DM group and the control group (P 0.01T2DM), which had a higher frequency than that in the control group (P0.05N). The number of GAD65-T cells in the control group was significantly higher than that in the control group (P < 0.05). The positive rates of GAD65-T cells positive T2DM and control group were 71.4 / 28 / 28 / 32.513 / 40 / 0.40 cases of T2DM subgroup respectively. The results showed that GAD65-T cells positive group had lower BMI, lower blood glucose control and lower fasting C-peptide level than the negative group. Conclusion GAD65-T cells are present in some T2DM patients with negative GAD65-Ab. The detection of GAD65-T cells combined with Elispot and GAD65-Ab can significantly increase the detection rate of Lada.
【作者单位】：福建医科大学附属泉州第一医院;解放军第306医院内分泌科;中南大学糖尿病中心;
【基金】：福建省自然科学基金项目计划(2015J01517) 泉州市科技计划项目(2016Z030)
【分类号】：R587.1

【相似文献】