Immunologic activity in the small intestinal mucosa of pediatric patients with type 1 diabetes

Diabetes. 2003 Sep;52(9):2287-95. doi: 10.2337/diabetes.52.9.2287.

Abstract

Involvement of gut immune system has been implicated in the pathogenesis of type 1 diabetes. However, few studies have been performed on the gut mucosa from patients with type 1 diabetes. Thus, we characterized the stage of immune activation in jejunal biopsy samples from 31 children with type 1 diabetes by immunohistochemistry, in situ hybridization, and RT-PCR. We found enhanced expressions of HLA-DR, HLA-DP, and intercellular adhesion molecule-1 by immunohistochemistry even on structurally normal intestine of patients with type 1 diabetes and no signs of celiac disease. In addition, the densities of IL-1 alpha- and IL-4-positive cells detected by immunohistochemistry and IL-4 mRNA-expressing cells evaluated by in situ hybridization were increased in the lamina propria in patients with type 1 diabetes and normal mucosa. Instead, the densities of IL-2, gamma-interferon (IFN-gamma), and tumor necrosis factor alpha-positive cells, the density of IFN-gamma mRNA positive cells, and the amounts of IFN-gamma mRNA detected by RT-PCR correlated with the degree of celiac disease in patients with type 1 diabetes. Our study supports the hypothesis that a link exists between the gut immune system and type 1 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antibodies
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Female
  • Gene Expression / immunology
  • Genotype
  • HLA Antigens / genetics
  • Histocompatibility Antigens Class II / analysis
  • Histocompatibility Antigens Class II / immunology
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization
  • Intercellular Adhesion Molecule-1 / analysis
  • Intercellular Adhesion Molecule-1 / immunology
  • Interferon-gamma / genetics
  • Interleukin-1 / genetics
  • Interleukin-2 / genetics
  • Interleukin-4 / genetics
  • Intestinal Mucosa / immunology*
  • Jejunum / chemistry
  • Jejunum / immunology*
  • Ki-67 Antigen / analysis
  • Male
  • Phosphorus Radioisotopes
  • RNA, Messenger / analysis
  • Receptors, CCR4
  • Receptors, CCR5 / genetics
  • Receptors, Chemokine / genetics
  • Reverse Transcriptase Polymerase Chain Reaction
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Antibodies
  • CCR4 protein, human
  • HLA Antigens
  • Histocompatibility Antigens Class II
  • Interleukin-1
  • Interleukin-2
  • Ki-67 Antigen
  • Phosphorus Radioisotopes
  • RNA, Messenger
  • Receptors, CCR4
  • Receptors, CCR5
  • Receptors, Chemokine
  • Tumor Necrosis Factor-alpha
  • Intercellular Adhesion Molecule-1
  • Interleukin-4
  • Interferon-gamma