Dimorphic histopathology of long-standing childhood-onset diabetes

Aims/hypothesis Childhood diabetes is thought to usually result from autoimmune beta cell destruction (type 1A) with eventual total loss of beta cells. Analysis of C-peptide in children characterised at diabetes onset for autoantibodies shows heterogeneous preservation of insulin secretion in long-s...

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Veröffentlicht in:	Diabetologia Jg. 53; H. 4; S. 690 - 698
Hauptverfasser:	Gianani, R, Campbell-Thompson, M, Sarkar, S. A, Wasserfall, C, Pugliese, A, Solis, J. M, Kent, S. C, Hering, B. J, West, E, Steck, A, Bonner-Weir, S, Atkinson, M. A, Coppieters, K, von Herrath, M, Eisenbarth, G. S
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01.04.2010 Springer-Verlag Springer Springer Nature B.V
Schlagworte:	Adolescent Adult African Americans Age of Onset Apoptosis Autoantibodies Autoantibodies - blood Autoimmune diabetes Autopsies Biological and medical sciences blood C-Peptide C-Peptide - blood Child Child, Preschool Childhood diabetes Diabetes Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 1 - immunology Diabetes Mellitus, Type 1 - pathology Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Heterogeneity of diabetes Hispanic people Histocompatibility Testing Histopathology HLA DR3 HLA DR4 HLA-DR Antigens Human Physiology Humans Hyperinsulinism Hyperinsulinism - pathology immunology Insulin insulin-dependent diabetes mellitus Insulin-Secreting Cells Insulin-Secreting Cells - pathology Internal Medicine Islet autoantibodies Male Medical sciences Medicine Medicine & Public Health Metabolic Diseases Middle Aged Organ donors Pancreas Pancreas - pathology Pathology Pathology of childhood diabetes Patterns of beta cell loss Peptides Sex Characteristics Tissue Donors United States > US Islet autoantibodies Childhood diabetes Type 1 diabetes HLA DR3 HLA DR4 Autoimmune diabetes Patterns of beta cell loss Pathology of childhood diabetes Heterogeneity of diabetes Organ donors Endocrinopathy Autoimmunity Immunopathology HLA-System Langerhans islet Autoantibody Autoimmune disease Anatomic pathology Histopathology Donor β Cell Endocrine pancreas
ISSN:	0012-186X, 1432-0428, 1432-0428
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Zusammenfassung:	Aims/hypothesis Childhood diabetes is thought to usually result from autoimmune beta cell destruction (type 1A) with eventual total loss of beta cells. Analysis of C-peptide in children characterised at diabetes onset for autoantibodies shows heterogeneous preservation of insulin secretion in long-standing diabetes. The aim of this study was to characterise the pancreases of childhood-onset diabetes in order to define the pathological basis of this heterogeneity. Methods We evaluated 20 cadaveric organ donor pancreases of childhood-onset long-term patients for disease heterogeneity and obtained corresponding C-peptide measurements. Results Pancreases from the majority of cadaveric donors contained only insulin-deficient islets (14 of 20). The remaining six patients (30%) had numerous insulin-positive cells within at least some islets, with two different histological patterns. Pattern A (which we would associate with type 1A diabetes) had lobular retention of areas with ‘abnormal' beta cells producing the apoptosis inhibitor survivin and HLA class I. In pattern B, 100% of all islets contained normal-appearing but quantitatively reduced beta cells without survivin or HLA class I. Conclusions/interpretation Our data demonstrate that C-peptide secretion in long-standing diabetic patients can be explained by two different patterns of beta cell survival, possibly reflecting different subsets of type 1 diabetes.
Bibliographie:	http://dx.doi.org/10.1007/s00125-009-1642-y ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	0012-186X 1432-0428 1432-0428
DOI:	10.1007/s00125-009-1642-y