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Cellular immune responses to human islet proteins in antibody-positive type 2 diabetic patients.

  1. B M Brooks-Worrell,
  2. R Juneja,
  3. A Minokadeh,
  4. C J Greenbaum and
  5. J P Palmer
  1. Department of Medicine, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington 98108, USA. bbrooks@u.washington.edu
    Diabetes 1999 May; 48(5): 983-988. https://doi.org/10.2337/diabetes.48.5.983
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    Abstract

    Type 1 diabetes is a cell-mediated autoimmune disease characterized by autoantibody and peripheral blood mononuclear cell (PBMC) reactivity to islet cell proteins. Type 2 diabetes is not an autoimmune disease but rather results from both insulin resistance and a nonautoimmune insulin secretory defect. There is, however, a group of phenotypic type 2 diabetic patients who have islet autoantibodies that are similar to those of type 1 diabetic patients. In this study, we investigated, using cellular immunoblotting, whether type 2 diabetic patients positive for islet autoantibodies have PBMC responses to islet proteins. We observed that autoantibody negative (Ab-) type 2 diabetic patients (n = 9) and normal control subjects (n = 12) demonstrated PBMCs responsive to 0-3 molecular weight regions. In contrast, autoantibody positive (Ab+) type 2 diabetic patients (n = 11) demonstrated PBMC responses to 3-18 molecular weight regions, similar to that of type 1 diabetic patients (responsive to 4-18 molecular weight regions). PBMCs from over 90% of the Ab+ type 2 and type 1 diabetic patients were observed to proliferate to islet proteins in the vicinity of 97 kDa. In contrast, 65-90% of type 1 diabetic patients had responsive PBMCs for islet proteins in most of the molecular weight regions, whereas <60% of the Ab+ type 2 diabetic patients had PBMCs responsive to the same molecular weight proteins. Ab+ type 2 diabetic patients appear to be heterogeneous with respect to cellular reactivity to islet proteins. Some subjects demonstrate PBMC responses similar to those of "classic" type 1 diabetic patients, whereas others have PBMC responses potentially distinct from type 1 diabetic patients.

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    May 1999, 48(5)
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    Cellular immune responses to human islet proteins in antibody-positive type 2 diabetic patients.
    B M Brooks-Worrell, R Juneja, A Minokadeh, C J Greenbaum, J P Palmer
    Diabetes May 1999, 48 (5) 983-988; DOI: 10.2337/diabetes.48.5.983

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    Cellular immune responses to human islet proteins in antibody-positive type 2 diabetic patients.
    B M Brooks-Worrell, R Juneja, A Minokadeh, C J Greenbaum, J P Palmer
    Diabetes May 1999, 48 (5) 983-988; DOI: 10.2337/diabetes.48.5.983
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