RESUMO
In some cases patients with Type 2 (non-insulin-dependent) diabetes mellitus fail to respond to treatment with oral hypoglycaemic agents. These patients may respond in the same way as Type 1 (insulin-dependent) diabetic patients. Cellular immune aggression (defined as the capacity of peripheral mononuclear cells to inhibit stimulated insulin secretion by dispersed rat islet cells), insulin autoantibodies, C-peptide response and HLA antigens were determined in 31 Type 2 diabetic patients with secondary failure to oral hypoglycaemic agents and in 22 control subjects. Nine (29.03%) of the 31 Type 2 diabetic patients showed positive cellular immune aggression (2 SD below control group) and 22 (70.97%) presented no cellular immune aggression. There was a relationship between positive cellular immune aggression and each of the following parameters: age, body mass index and microangiopathy. No correlation was found between positive cellular immune aggression and glycaemia, HbA1, blood lipids or atherosclerosis. Patients with positive cellular immune aggression showed a significantly lower glucagon-stimulated C-peptide response vs those with no cellular immune aggression. Within a sub-group of patients who had never been treated with insulin, insulin autoantibodies were present in four of six patients with positive cellular immune aggression. DR2 antigen was found with decreased frequency in patients whereas no DR3/DR4 heterozygotes were observed. Our data support the hypothesis that a group of Type 2 diabetic patients with secondary failure to oral hypoglycaemic agents presented autoimmunity towards pancreatic Beta cells.
Assuntos
Formação de Anticorpos , Autoanticorpos/sangue , Peptídeo C/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/imunologia , Antígenos HLA/sangue , Antígenos HLA-DR/sangue , Hipoglicemiantes/uso terapêutico , Imunidade Celular , Anticorpos Anti-Insulina/sangue , Análise de Variância , Animais , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 2/sangue , Feminino , Glucagon , Antígenos HLA-DQ/sangue , Humanos , Insulina/metabolismo , Secreção de Insulina , Ilhotas Pancreáticas/imunologia , Ilhotas Pancreáticas/metabolismo , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Ratos , Valores de Referência , Falha de TratamentoRESUMO
The prevalence of class I and class II HLA antigen was analyzed in 14 patients (12 males, two females) with Whipple's disease, diagnosed an average of 9.7 yr (range 6 months to 25 yr) before the typing. They were compared with 174 healthy control subjects of the same geographic area in Argentina. Class I antigens (locus A, B, C) were studied by lymphocytotoxic test, and class II antigens (locus DR, DQ) were detected by the double immunofluorescence technique. HLA-B27 was positive in one patient (7.7%) and in 4% of the control population. No significant association was found with the antigens tested. We observed no difference in the clinical picture or in the frequency of arthralgias, compared with those reported in the literature. Our data suggest that there is no conclusive proof of an association between HLA-B27 and Whipple's disease.
Assuntos
Antígenos HLA/sangue , Antígenos HLA-D/sangue , Doença de Whipple/imunologia , Idoso , Idoso de 80 Anos ou mais , Argentina , Feminino , Imunofluorescência , Antígeno HLA-B27/sangue , Humanos , Imunofenotipagem , Masculino , Pessoa de Meia-IdadeRESUMO
A population of 62 unrelated homogeneous Argentinian celiac pediatric patients were typed for HLA-A,B,C,DR, and DQ antigens. The association between celiac disease and the DR3 and DR7 antigens was confirmed. The specificity DQw2 was present in 95.2 per cent of the patients. Nevertheless, it was of interest that the most significant phenotypes observed were DR3/DR7, DR7/DR5, and DR3/DR5. The significance of these findings is discussed.
Assuntos
Biomarcadores , Doença Celíaca/genética , Antígenos HLA-D/genética , Alelos , Argentina , Doença Celíaca/etnologia , Doença Celíaca/imunologia , Criança , Suscetibilidade a Doenças , Etnicidade , Feminino , Antígenos HLA-DQ/genética , Antígenos HLA-DR/genética , Humanos , Itália/etnologia , Masculino , Espanha/etnologiaRESUMO
Seventy five patients with acute and chronic active hepatitis (CAH) were studied by indirect immunofluorescence with monoclonal antibodies for the presence of hepatitis B surface antigen (HBsAg) on peripheral blood mononuclear cells (PBMC). The viral surface antigen was detected in the PBMC of all the patients with hepatitis B virus (HBV)-induced CAH and in acute patients with more than 2 months of evolution. No HBsAg was detected in the samples obtained from 12 normal controls or from 14 non-A, non-B CAH patients. Analysis of PBMC subsets revealed that HBsAg was present in non-T cells; dual fluorescence studies showed HBsAg on surface Ig-positive lymphocytes. The binding of anti-HBs monoclonal antibodies was higher than that of a goat anti-HBs serum, and the highest reactivity was observed with an antibody against the pre-S(2)-region sequence. Both HBsAg and hepatitis B core antigen (HBcAg) were also detected in lysates of PBMC by dot blot analysis.
Assuntos
Linfócitos B/imunologia , Antígenos de Superfície da Hepatite B/análise , Hepatite B/imunologia , Hepatite Crônica/imunologia , Doença Aguda , Adulto , Feminino , Antígenos do Núcleo do Vírus da Hepatite B/análise , Antígenos E da Hepatite B/análise , Hepatite C/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Linfócitos T/imunologiaRESUMO
Peripheral blood leukocyte DNA from 31 donors, previously typed as HLA-B35, was digested with EcoRV and analyzed by Southern transfer and hybridization to an HLA class I probe. Out of 31 HLA-B35 positive (+) individuals, 24 showed a 4.6-kb band, previously associated with the B35 allele by Cohen et al. (Proc Natl Acad Sci USA 80:6289-6292). The HLA-B35 allele has a strong linkage disequilibrium (70%) with the Cw4 allele. All samples having the 4.6-kb band corresponded to HLA-B35+, Cw4+ cells, whereas those lacking the band came from HLA-B35+, Cw4-negative (-) cells. Five HLA-B35-, Cw4+ samples were also studied and none showed the band. An HLA-B locus-specific probe gave a strong hybridization signal to this fragment, whereas an HLA-C locus-specific probe revealed different bands. The results suggest that the 4.6-kb fragment contains the B35 gene. Digestion with other restriction enzymes, located the polymorphic site to the 3' end of the gene. Analysis of 18 additional individuals with other specificities of the "4c" antigenic cluster (HLA-B18, B51, B52 and B53) showed that the EcoRV/4.6 kb-band was also present in 5/5 B52 cells and 4/4 B53 samples.
Assuntos
Genes MHC Classe I , Antígenos HLA-B/genética , Alelos , DNA/genética , Sondas de DNA de HLA , Antígeno HLA-B35 , Antígenos HLA-C/genética , Humanos , Polimorfismo de Fragmento de Restrição , Mapeamento por RestriçãoRESUMO
Fifty-one patients with chronic active hepatitis were typed for their HLA-A, B, C, and DR antigens. We observed a significant increase in the antigen frequency of HLA B35 in patients compared with controls.