Cell-Mediated Anti-Islet—Cell Immune Response: Clinical Experience and Lessons from Animal Models

McEvoy, Robert; Thomas, Nancy M.

doi:10.1007/978-1-4612-3218-6_8

Autoimmunity and the Pathogenesis of Diabetes

1990

DOI: 10.1007/978-1-4612-3218-6_8

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Cell-Mediated Anti-Islet—Cell Immune Response: Clinical Experience and Lessons from Animal Models

Robert McEvoy¹,

Nancy M. Thomas²

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1991

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“…The hypothesis that autoimmunity plays a role in the pathogenesis of Type 1 (insulin-dependent) diabetes mellitus has been supported by many observations in both humans [1,2] and in spontaneously diabetic rodents [3][4][5]. While it is well-known that the development of glucose intolerance during pregnancy (gestational diabetes) increases the risk of subsequently developing permanent diabetes to as high as 35% [6][7], the role of autoimmunity in the pathogenesis of gestational diabetes has not been extensively studied.…”

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Gestational diabetes mellitus: evidence for autoimmunity against the pancreatic Beta cells

1991

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Diabetes mellitus is a frequent transient or rare permanent complication of pregnancy. The role of autoimmune phenomena in this gestational form of diabetes is incompletely understood. We have examined sera from 312 pregnant women who had abnormal glucose tolerance (based on a screening examination during the second trimester) for the presence of islet cell surface antibodies or insulin autoantibodies. Fifty-eight of these women were lost to follow-up. Of the remaining subjects, 144 (57.1%) had gestational diabetes diagnosed by formal glucose tolerance testing and the others (42.9%) were normal. Sixty percent of the women with gestational diabetes eventually required insulin to control their blood glucose during pregnancy. One serum from the non-diabetic women was positive for insulin antibodies (0.9%); 8 of the sera from the patients with gestational diabetes were positive (5.6%). Subsequent analysis revealed that all nine of the women whose sera were positive for insulin autoantibodies had been treated with insulin previously. Islet cell surface antibodies were strongly correlated with gestational diabetes. Forty-five of 144 gestational diabetic sera were positive (31.3%) whereas only 9 of 108 suspect control sera (8.3%) and 7 of 60 unknown sera (11.7%) were positive. These data suggest that a high percentage of pregnant women who screen positive for glucose intolerance have serological evidence of an autoimmune response against the pancreatic islets, in spite of the state of relative immune tolerance during pregnancy. These data suggest that autoimmune phenomena may play a role in gestational diabetes and that the presence of islet cell antibodies can predict insulin-requiring gestational diabetes.

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confidence: 99%

Gestational diabetes mellitus: evidence for autoimmunity against the pancreatic Beta cells

1991

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Cell-Mediated Anti-Islet—Cell Immune Response: Clinical Experience and Lessons from Animal Models

Cited by 1 publication

References 87 publications

Gestational diabetes mellitus: evidence for autoimmunity against the pancreatic Beta cells

Gestational diabetes mellitus: evidence for autoimmunity against the pancreatic Beta cells

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