T-cell response to proinsulin and insulin in type 1 and pretype 1 diabetes

D Dubois-LaForgue, JC Carel, PF Bougnères… - Journal of clinical …, 1999 - Springer
D Dubois-LaForgue, JC Carel, PF Bougnères, JG Guillet, C Boitard
Journal of clinical immunology, 1999Springer
Insulin-dependent diabetes mellitus (IDDM) results from the selective destruction of
pancreatic β cells by a T cell-mediated autoimmune process. Insulin and proinsulin are the
only known β cell-specific autoantigens. Using short-term cultures of freshly isolated
peripheral blood mononuclear cells, we evaluated T-cell responses to proinsulin and to
insulin in IDDM patients and individuals at risk for IDDM. A proliferative T-cell response to
proinsulin was observed in only 2 of 26 recent-onset IDDM subjects and 2 of 12 long …
Abstract
Insulin-dependent diabetes mellitus (IDDM) results from the selective destruction of pancreatic β cells by a T cell-mediated autoimmune process. Insulin and proinsulin are the only known β cell-specific autoantigens. Using short-term cultures of freshly isolated peripheral blood mononuclear cells, we evaluated T-cell responses to proinsulin and to insulin in IDDM patients and individuals at risk for IDDM. A proliferative T-cell response to proinsulin was observed in only 2 of 26 recent-onset IDDM subjects and 2 of 12 long-standing IDDM subjects and was associated with a proliferative response to insulin. In contrast, 5 of 13 islet cell autoantibody-positive first-degree relatives of IDDM patients showed a proliferative response to proinsulin alone, 3 of 13 to insulin alone, and 1 of 13 to both insulin and proinsulin. Overall, 9 of 13 ICA-positive first-degree relatives responded to either proinsulin or insulin. We observed an inverse relationship between antiinsulin antibodies and T-cell responses to insulin in ICA-positive first-degree relatives but not in long-standing IDDM patients. Our data indicate that proinsulin is a major antigen in IDDM and, further, illustrate the difference between the autoimmune response to insulin and the immune response to exogenous insulin.
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