成人隐匿性自身免疫性糖尿病患者CD4+CD25+T细胞的变化研究

目的：通过观察成人隐匿性自身免疫性糖尿病（LADA）患者CD4^＋CD25^＋T细胞的变化并与速发性1型糖尿病（T1 DM）比较，了解成人隐匿性自身免疫性糖尿病患者T细胞免疫功能的变化及与1型糖尿病的异同点。方法：LADA组24例，速发性T1DM18例，对照组20例，应用流式细胞技术测定3组人选者T细胞表面分子CD4、CD8、CD25、CD4^＋CD25^＋、CD8^＋CD25^＋、CD4^＋CD25^＋CD62L^＋，以百分比表示各表面分子阳性T细胞占外周血淋巴细胞的比例。结果：LADA与T1DM组CD4^＋T细胞、CD4／CD8比值明显高于健康对照组（P〈0．01），LADA与T1DM对比无差异。LADA组CD25^＋、CD4^＋CD25^＋、CD4^＋CD25^＋CD62L^＋T细胞高于健康对照组（P〈0．05），明显高于T1 DM组（P〈0．01）。T1 DM组CD25^＋、CD4^＋CD25^＋、CD4^＋CD25^＋CD62L^＋T细胞略低于健康对照组，但无统计学意义（P〉0．05）。结论：LADA患者外周血中诱导免疫耐受的CD4^＋CD25^＋、CD4^＋CD25^＋CD62L^＋T细胞较对照组升高并明显高于T1 DM患者。LADA患者胰岛B细胞功能下降较速发性T1 DM患者相对缓慢可能与CD4^＋CD25^＋T细胞的免疫保护有关。

Changes of CD4 + CD25 +T cells in patients with Latent autoimmune diabetes in adults

Objective:To observe the changes of CD4+CD25+T cells in patients with Latent autoimmune diabetes in adults.Methods:The lymphocyte subpopulations(CD4+,CD8+,CD25+,CD4+CD25+,CD8+CD25+,CD4+CD25+CD62L+ T cells) in peripheral blood mononuclear were in 24 LADA, 18 type 1 diabetic with rapid progression, and 20 normal control by flow cytometric. We assessed the immune changes of T cells subsets of LADA and compared with type 1 diabetic with rapid progression.Results:(1)Patients with LADA and type1 diabetes had higher CD4+T cells and CD4-CD8- ratio compared with patients type 2 diabetes(P<0.05). There were no differences between LADA and type 1 diabetes(P>0.05). (2)The CD25+, CD4+CD25+, CD4+CD25+CD62L+T cells in LADA patients was higher than normal control(P<0.05), and more higher than type 1 diabetes(P<0.01).Conclusion:The increasement of regulatory T cells may play an important protective role in development of LADA.