Incidence of Pancreatic Islet-Cell Antibodies in Insulin Dependent Diabetics

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  • Nagaoka Kengo
    Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • Sakurami Takehiko
    Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • Nabeya Noboru
    Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • Imura Hiroo
    Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • Kuno Shotaro
    Osaka Red Cross Hospital

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Other Title
  • インスリン依存性糖尿病患者における膵ラ氏島抗体
  • インスリン イゾンセイ トウニョウビョウ カンジャ ニ オケル スイ ラシトウ

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Abstract

Environmental and genetic factors have been considered important in the pathogenesis of diabetes mellitus. However, in insulin dependent diabetics (IDD), recent investigations suggest that an autoimmune process may be responsible for its pathogenesis.<BR>The clinical association between IDD and autoimmune diseases and a high rate of occurrence of organ-specific antibodies such as antithyroid antibodies in IDD have already been reported. Also, using an indirect immunofluorescence technique, circulating antibodies to pancreatic islet cells have recently been detected by many research groups in the United Kingdom.<BR>However, islet-cell antibodies (I.C.Ab.) were first described by Bottazzo et al. and Mac-Cuish et al. in the sera of IDD with polyendocrine diseases.<BR>Irvine et al. clarified that I.C.Ab. were most common in newly diagnosed IDD of recent onset and the prevalence of humoral I.C.Ab. was strongly dependent on the duration of the diabetes. Moreover, they have also shown that diabetics who did not require insulin for treatment but who were I.C.Ab.-positive showed a significant tendency to subsequently require insulin.<BR>In collaboration with W. J. Irvine of the Royal Infirmary (Edinburgh), pancreatic islet-cell antibodies were detected by us in IDD. Fresh postmortem snap-frozen pancreatic tissue of blood group 0 and antihuman IgG-FITC (Wellcome) were used. Six out of 123 diabetics treated with insulin had I.C.Ab. in their sera.<BR>The prevalence of I.C.Ab. in the control population was low, at 0.5%(p<0.005). The inverse relationship observed between the prevalence of these antibodies and duration of the diabetes was the same as that reported by Dr. Irvine. I.C.Ab. were present in 16% of IDD during the first year and in 8.3% between 1 and 3 yr after the disease onset.<BR>The prevalence of I.C. Ab. fell to 0 % at more than 4 yr.

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