| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 145
| Issue : 6 | Page : 767-776 |
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Peripheral blood mononuclear cells of patients with latent autoimmune diabetes secrete higher levels of pro- & anti-inflammatory cytokines compared to those with type-1 diabetes mellitus following in vitro stimulation with β-cell autoantigens
Darshan Badal1, Rajendra Kumar2, Mahinder Paul1, Devi Dayal3, Anil Bhansali1, Sanjay Kumar Bhadada1, Rajesh Kumar4, Naresh Sachdeva1
1 Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
2 University Institute of Pharmaceutical Sciences (UIPS), Chandigarh, India
3 Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India
4 Department of Statistics, Panjab University, Chandigarh, India
Correspondence Address:
Naresh Sachdeva
Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijmr.IJMR_1563_15
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Background & objectives: Type-1 diabetes mellitus (T1DM) and latent autoimmune diabetes in adults (LADA) share similar pathological features but differ in age of onset and progression. There is a scarcity of information on differences in CD4+ T-cell responses, particularly, cytokine secretion, between the two forms of autoimmune diabetes. Here proliferative potential and concentration of pro- and anti-inflammatory cytokines secreted by peripheral blood mononuclear cells (PBMCs) of T1DM and LADA patients were compared, after in vitro stimulation with β-cell autoantigens.
Methods: A total of 19 patients with LADA, 37 with T1DM and 20 healthy controls were compared on the basis of lymphocyte proliferation and secretion of pro- and anti-inflammatory cytokines belonging to different T-helper types after in vitro stimulation of PBMCs with insulin and glutamic acid decarboxylase 65 (GAD65).
Results: Following insulin stimulation, LADA group secreted higher concentration of interleukin-17 (IL-17) (P=0.02) and had higher proportion of interferon gamma (IFN-γ) secretors (P<0.001) than T1DM group. Post-GAD65 stimulation, higher proportion of LADA patients secreted IL-23 than T1DM group (P=0.02). Proportion of responders , as well as levels of secreted IL-10, were significantly higher in LADA than T1DM group, following stimulation with both insulin (P=0.01) and GAD65 (P=0.03). A significant positive correlation was observed between body mass index and IL-17 levels (r=0.41, P=0.04) and fasting plasma C-peptide with IL-10 levels (r=0.37, P=0.04).
Interpretation & conclusions: There are differences in the portfolio of cytokine secretion in diabetic subjects with varying rates of β-cell destruction as LADA subjects secrete higher levels of both pro- and anti-inflammatory cytokines on exposure to β-cell autoantigens, thus highlighting another distinguishing feature in the pathophysiology of the two forms of autoimmune diabetes.
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