【摘要】 目的:探讨羧基肽酶H抗体(CPH-Ab)阳性的成人隐匿性自身免疫性糖尿病(LADA)患者外周血T细胞免疫的特点。方法:选取CPH-Ab+LADA患者42例,2型糖尿病组(T2DM)患者20例和健康对照22例,分离外周血单个核细胞;自制人CPH蛋白,应用酶联免疫斑点(ELISPOT)技术检测并比较各组在CPH诱导下分泌IFN-γ的Th1和分泌IL-4的Th2细胞数,计算Th1与Th2比值(Th1/Th2)。结果:与健康对照和T2DM比较,CPH-Ab+LADA患者的IFN-γ-T和IL-4-T细胞数无异常增多,Th1/Th2亦无统计学差异(P>0.05);但22例短病程(<3年)CPH-Ab+患者的CPH-IL-4-Th2细胞数较T2DM患者和正常对照均显著升高(1.8 vs.0.2和0.3,均P<0.05),但未发现任何因素与该斑点数相关。各组间的T细胞针对植物血凝素的反应均无统计学差异。结论:CPH未直接诱导LADA的细胞免疫破坏反应,CPH反应性T细胞标志的可能是一进展相对缓慢的、胰岛β细胞的自身免疫过程。更多还原

【Abstract】 Objective To explore the characteristics of T cell immunity in peripheral blood of patients with carboxypeptidase-H antibody(CPH-Ab).Methods Forty-two latent autoimmune diabetes in adults(LADA) patients with CPH-Ab+ alone,20 Type 2 diabetes mellitus patients(T2DM),and 22 healthy controls were selected and their peripheral blood mononuclear cells were isolated.Human recombinant carboxypeptidase(CPH) protein was expressed and further used as a stimulant in Enzyme-linked immunospot(ELISPOT) assay to detect IFN-γ-Th1 and IL-4-Th2 cells in the 3 groups.Th1/Th2 ratios were also calculated.CPH-Ab and glutamic acid decarboxylase antibody(GAD-Ab) were determined by radioligand assay.Results Compared with healthy controls and T2DM,IFN-γ-Th1 and IL-4-Th2 numbers did not increase significantly in CPH-Ab+ group,nor did the Th1/Th2 ratios(P>0.05).We further divided the CPH-Ab+ patients into a short duration group(n=22) and a long duration subgroup(n=20) according to the duration of 3 years.CPH-IL-4-T in the short duration subgroup was significantly higher than that in T2DM and healthy controls(1.8 vs.0.2 and 0.3,both P<0.05) and we did not find any factor that was significantly correlated with the IL-4 spots number.There were not any significant differences in T cell responses to phaseolus vulgaris agglutinin(PHA) among all groups(P>0.05).Conclusion CPH does not directly involve in the cellular pathological mechanism of LADA.Anti-CPH immunity may be associated with more slowly aggressive beta cell autoimmunity.更多还原