Reactivity to Human Islets and Fetal Pig Proislets by Peripheral Blood Mononuclear Cells From Subjects With Preclinical and Clinical Insulin-Dependent Diabetes

  1. Peter G Colman
  1. Walter and Eliza Hall Institute of Medical Research, Ludwig Institute for Cancer Research, Endocrine Laboratory, The Royal Melbourne Hospital Parkville, Victoria, Australia
  1. Address correspondence and reprint requests to Professor L.C. Harrison, Walter and Eliza Hall Institute, Royal Melbourne Hospital, PO 3050, Victoria, Australia.


A simple, direct assay for T-lymphocyte reactivity to islet antigen(s) in human insulin-dependent diabetes mellitus (IDDM) should facilitate preclinical diagnosis and the evaluation of intervention therapy to avert autoimmune-mediated β-cell destruction. In subjects with preclinical or clinical IDDM, we measured the reactivity of peripheral blood mononuclear cells (PBMCs) incubated over 6 days with either adult human islets or fetal pig proislets, or other fetal pig tissues, and with human insulin. With islets, the stimulation index (SI) of [3H]thymidine uptake by PBMCs exceeded the mean + 2SD of control subjects in 6 of 6 preclinical subjects (SI 8.7 ± 3.7), 7 of 11 clinical subjects (SI 5.2 ± 3.4), and 1 of 12 control subjects (SI 2.7 ± 1.7); with insulin, the responses were less in frequency and magnitude, being 4 of 6 (2.7 ± 1.6), 3 of 11 (2.2 ± 1.1), and 0 of 12 (1.20 ± 0.55), respectively. The mean responses to islets of PBMCs from preclinical and clinical subjects differed significantly from control subjects (P < 0.02 by 2-tailed Kruskal-Wallis test). Secretion of granulocyte macrophage colony–stimulating factor by PBMCs over 6 days was assayed in the preclinical group and generally paralleled the uptake of [3H]thymidine. PBMC reactivity to islets appeared to be at least as sensitive a marker of preclinical IDDM as autoantibodies to a 64,000-Mr protein, presumably the enzyme glutamic acid decarboxylase, in fetal pig proislets. In conclusion, islet-reactive T lymphocytes in subjects with preclinical and clinical IDDM can be identified in bulk culture of PBMCs. Detection of these autoreactive T lymphocytes should be of value in the diagnosis of preclinical IDDM and in monitoring the effects of immunotherapy.

  • Received February 18, 1991.
  • Revision received March 28, 1991.
  • Accepted March 28, 1991.
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