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目的 :探讨成人隐匿性自身免疫糖尿病 (LADA)患者Th1和Th2细胞因子谱的改变及其与临床特征的关系。方法 :采用酶联免疫吸附法 (ELISA )检测 2 3例LADA、2 1例 2型糖尿病 (T2DM )和 2 0例正常人血浆IL 2水平 ,及PBMC培养上清IL 4和IFN γ水平。结果 :( 1)血IL 2水平LADA组高于T2DM及正常对照组。 ( 2 )无PHA刺激的上清IL 4水平LADA组低于T2DM及正常对照组 ( 4 64vs 6 5 9,7 0 4) ;经PHA刺激后 ,LADA及正常对照低于T2DM组 ( 12 63 ,11 49vs 2 6 86)。 ( 3 )无论有无PHA刺激 ,上清IFN γ水平LADA组均高于T2DM及正常对照组 ( 188 0 0vs 2 9 14 ,11 96;182 0 66vs 3 70 2 0 ,796 64 )。 ( 4 )未予PHA刺激的PBMC培养上清IFN γ/IL 4水平LADA组高于正常对照组 ( 4 5 0 6vs 1 3 9) ;经PHA刺激后 ,LADA组高于T2DM组和正常对照组 ( 10 9 5 8vs8 12 ,60 68) ,T2DM组低于正常对照组。 ( 5 )LADA患者未予PHA刺激的IFN γ分泌水平与年龄、空腹血糖呈正相关 ,与GADA呈负相关。结论 :LADA患者Th1样细胞因子IL 2和IFN γ水平升高而Th2样细胞因子IL 4水平下降 ,存在着Th1/Th2比例失衡。
Objective: To investigate the changes of Th1 and Th2 cytokines profiles in adults with latent autoimmune diabetes (LADA) and its relationship with clinical features. Methods: Serum IL 2 levels in 23 LADA patients, 21 T2DM patients and 20 normal controls were detected by enzyme-linked immunosorbent assay (ELISA), and the levels of IL-4 and IFN-γ in PBMC culture supernatants were detected. Results: (1) Blood IL 2 level in LADA group was higher than that in T2DM group and normal control group. (2) The level of IL-4 in the non-PHA-stimulated supernatant was lower in LADA group than in T2DM and normal control group (648 vs 659, 704). After PHA stimulation, LADA and normal control were lower than those in T2DM group (12.63, 11 49 vs. 2 6 86). (3) The serum IFN-γ level in supernatant of LADA group was higher than that of T2DM group and normal control group (188 0 0vs 2 9 14, 11 96; 182 0 66 vs 3 70 2 0, 796 64) with or without PHA stimulation. (4) IFNγ / IL-4 level in the culture supernatant of PBMC without PHA stimulation was higher than that in the normal control group (4560 vs 399). After stimulation with PHA, the LADA group was higher than the T2DM group and the normal control group (10 9 5 8vs8 12, 60 68), T2DM group was lower than the normal control group. (5) The levels of IFN-γsecreted without PHA in LADA patients were positively correlated with age and fasting blood glucose, but negatively correlated with GADA. CONCLUSIONS: Th1-like cytokines IL 2 and IFN γ levels are elevated in LADA patients, whereas Th2-like cytokines IL 4 levels are decreased. There is an imbalance of Th1 / Th2 ratio.