A prospective analysis of antibodies reacting with pancreatic islet cells in insulin-dependent diabetic children

Lernmark, Åke; Hägglöf, Bruno; Freedman, Zachary R.; Irvine, Jennifer C; Ludvigsson, Johnny; Holmgren, Gösta

doi:10.1007/bf00253410

Cited by 65 publications

(35 citation statements)

References 12 publications

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“…However, in three studies no relationship between persistence of ICA and residual B cell function has been observed [40][41][42]. Islet cell surface antibodies are independent of ICA [44] but strictly related to duration of disease [43,44]. Again no correlation was found between persistence of islet cell surface antibodies and B cell function [44].…”

Section: Immune Mechanisms In Relation To B Cell Functionmentioning

confidence: 99%

Prevalence of residual B cell function and its metabolic consequences in Type 1 (insulin-dependent) diabetes

Madsbad¹

1983

Diabetologia

102

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Summary. Several reports suggest that most patients have surviving B cells at the onset of Type 1 (insulin-dependent) diabetes. After starting insulin therapy, most have a transient improvement in B cell function which peaks between 2 and 6 months after diagnosis. Thereafter B cell function declines. However, even after 2 years most patients still display some residual B cell function. During the following 10-15 years, the prevalence of residual B cell function decreases to about 15% and stays at this level. At present it is unknown why patients with Type 1 diabetes have different degrees of B cell function after several years of disease. Age at onset is of importance for the first 10-15 years of disease. Patients with late onset have a higher prevalence of retained B cell function than patients with early onset. Both at the onset of disease and after the initial remission period, an improvement in glycaemic control results in improved B cell function but the effect is transient. The occurrence of islet cell antibodies, islet cell surface antibodies and the many abnormal cellular immunological parameters found in Type 1 patients have not been correlated to the degree of B cell function. The metabolic importance of even minimal endogenous insulin secretion on intermediate metabolism has been clearly demonstrated during insulin withdrawal. During hypoglycaemia, patients with B cell function have a greater glucagon and pancreatic polypeptide response than patients without. The nadir and recovery of blood glucose do not differ, but rates of lipolysis and ketogenesis are exaggerated in those without B cell function. Residual B cell function is clearly linked to clinical remission but seems to have little effect on metabolic control in daily life after years of diabetes. Only patients with considerable B cell function have markedly better metabolic control than patients without B cell function, but those with residual B cell function need a smaller daily dose of insulin to obtain the same degree of control. Whether residual B cell function protects against or delays the development of late complications is not clear.

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Section: Immune Mechanisms In Relation To B Cell Functionmentioning

confidence: 99%

Prevalence of residual B cell function and its metabolic consequences in Type 1 (insulin-dependent) diabetes

Madsbad¹

1983

Diabetologia

102

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“…Several studies have examined the prevalence of islet cell surface antibodies in Type 1 diabetes (Table 1) using fixed or living islet cell suspensions of human or rodent origin in an indirect immunofluorescence test. The prevalence of islet cell surface antibodies seems to parallel that of cytoplasmic antibodies [10] although the two assay systems do not always yield concordant results [1 1]. Again we believe that it will be necessary to determine the antibodies quantitatively.…”

Section: Islet Cell Surface Antibodiesmentioning

confidence: 99%

Islet cell antibodies ? Theoretical and practical implications

Lernmark¹,

Baekkeskov²

1981

Diabetologia

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“…We therefore studied both ICA and ICSA from the onset of diabetes to the honeymoon, i.e., during a six-month period. Lernmark et al (1981b) described in their report that the two antibodies might appear and disappear independently of each other. Also, there is no obvious explanation of why the prevalence of islet cell antibodies depends on the duration of the diabetic condition.…”

Section: Discussionmentioning

confidence: 96%

“…A prospective analysis of both ICA and ICSA in IDDM has been studied by Lernmark et al (1981b), but there is no report to date about the observation of ICA and ICSA during the course of diabetes. We therefore studied both ICA and ICSA from the onset of diabetes to the honeymoon, i.e., during a six-month period.…”

Section: Discussionmentioning

confidence: 99%

A clinical profile of insulin-dependent diabetes with islet cell cytoplasmic and cell surface antibodies.

Ohgawara¹,

Takei

Maruyama

et al. 1984

Tohoku J. Exp. Med.

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Both islet cytoplasmic and cell surface antibodies (ICA and ICSA) were studied from the onset of diabetes to the honeymoon in an insulin-dependent diabetic patient. The patient, a 24-year-old male, was admitted to the hospital because of ketoacidotic hyperglycemic precoma. Continuous subcutaneous infusion of a small dose of insulin was carried out for a couple of days followed by NPH-insulin injection. The dose was gradually decreased and on the 45th day after the onset, an oral hypoglycemic agent was substituted for insulin. The patient was followed up after discharge from the hospital and his disease was controlled well by diet and a hypoglycemic agent until he caught a common cold. He was then admitted again to the hospital because of hyperglycemia, and insulin injection was performed. Both ICA and ICSA were found independently of each other during the course of the disease. The ICSA, which was quantitatively determined by immunoassay using 125I-protein A, closely paralleled the clinical profile. However, the levels of quantitative ICSA were higher than normal, even though the patient's diabetes reached the honeymoon stage. These results suggest that quantitative ICSA has a strong association with the clinical profile in IDDM, and it may be a "marker" of islet cell damage during the diabetic period or a parameter for diabetic prognosis.

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A prospective analysis of antibodies reacting with pancreatic islet cells in insulin-dependent diabetic children

Cited by 65 publications

References 12 publications

Prevalence of residual B cell function and its metabolic consequences in Type 1 (insulin-dependent) diabetes

Prevalence of residual B cell function and its metabolic consequences in Type 1 (insulin-dependent) diabetes

Islet cell antibodies ? Theoretical and practical implications

A clinical profile of insulin-dependent diabetes with islet cell cytoplasmic and cell surface antibodies.

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