Abstract

Aims/HypothesisFulminant type 1 diabetes (FT1D) is a distinct subtype of type 1 diabetes and is fatal without immediate diagnosis and treatment. At present, there are no biomarkers for early and predictive detection of FT1D.MethodsFirst, we analyzed a total of 6 serum samples from 3 patients with FT1D (1 sample in the acute and 1 in the sub-acute phases from each patient) by seromic analysis. Second, titres of the antibody were measured by ELISA in sera from 30 patients with FT1D (both in the acute and sub-acute phases), 13 patients with FT1D in the chronic phase, 32 patients with autoimmune type 1 (type 1A) diabetes (T1AD), 30 patients with type 2 diabetes (T2D), 23 patients with autoimmune thyroid disease (AITD) and 31 healthy control subjects (HC).ResultsSeromic analysis revealed 9 antibodies which showed high signals from all 3 patients with FT1D in the acute phase. Among them, the titre of anti-CD300e antibody was significantly higher in FT1D patients in the acute phase than that in T1AD, T2D, AITD patients and HC, as determined by ELISA (P<0.01, respectively). The titre of anti-CD300e antibody was also higher in FT1D in the acute phase than that in the sub-acute phase (P = 0.0018, Wilcoxon signed-rank test). The titre of anti-LGALS3 antibody in FT1D patients in the acute phase did not differ from that in patients with FT1D in the sub-acute phase, T1AD, T2D, AITD and HC.Conclusion/InterpretationThe titre of a novel antibody, anti-CD300e, was high in sera from patients with FT1D. This antibody might be a diagnostic marker and provide new insight into the pathogenesis of FT1D.

Highlights

  • Fulminant type 1 diabetes (FT1D) is a distinct subtype of type 1 diabetes (T1D) characterized by a rapid onset and an insulin deficiency resulting from almost complete destruction of pancreatic beta cells even at the disease onset [1, 2]

  • The titre of anti-CD300e antibody was significantly higher in FT1D patients in the acute phase than that in Type 1A diabetes (T1AD), type 2 diabetes (T2D), autoimmune thyroid disease (AITD) patients and healthy control subjects (HC), as determined by ELISA (P

  • The titre of anti-CD300e antibody was higher in FT1D in the acute phase than that in the sub-acute phase (P = 0.0018, Wilcoxon signed-rank test)

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Summary

Introduction

Fulminant type 1 diabetes (FT1D) is a distinct subtype of type 1 diabetes (T1D) characterized by a rapid onset and an insulin deficiency resulting from almost complete destruction of pancreatic beta cells even at the disease onset [1, 2]. We have reported that CD4+CD45RA-Foxp3hi activated regulatory T-cells, which play a central role in the T-cell mediated immune response, are functionally impaired both in patients with FT1D and in patients with T1AD [15]. These findings suggest that both innate and acquired immune disorders might contribute to the development of FT1D

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