CD4+ T cell‒dominant insulitis in acute-onset type 1 diabetes mellitus associated with intraductal papillary mucinous adenoma

Ken Yajima, Yoichi Oikawa, Kentaro Ogata, Akinori Hashiguchi, Akira Shimada

研究成果: Article

抄録

The loss of insulin-producing pancreatic β-cells in Type 1 diabetes mellitus (DM) is presumably the result of a T cell‒mediated process. In general, CD8+ T cells are the predominant lymphocytes in the insulitis lesions, and CD4+ T cell‒dominant insulitis is very rare. We present a case of a 72-year-old woman presented with excessive thirst and a 3-month history of weight loss. She was in a state of ketosis, and her plasma glucose concentration and HbA1c value were elevated. Moreover, anti-islet autoantibodies were positive, thus acute-onset Type 1 DM was diagnosed. At the time of diagnosis, a tumour was detected in the pancreas; total pancreatectomy was carried out 2 months later. The pathological diagnosis was intraductal papillary mucinous adenoma. Immunohistochemical staining of a sample of non-tumorous pancreatic tissue revealed 13 insulitis lesions infiltrated by both CD4+ and CD8+ T cells, and interestingly there were more CD4+ T cells than CD8+ T cells in the lesions. Moreover, B cells and macrophages had also infiltrated the lesions, and these two cell frequencies were both positively correlated with CD4+ as well as CD8+ T cell frequencies. This was a rare case with acute-onset Type 1 DM characterized by CD4+ T cell-dominant insulitis. Proinflammatory cytokines that can promote β-cell apoptosis or CD8+ T cell function are reported to be secreted from CD4+ T cells. Thus, together with B cells and macrophages, CD4+ T cell‒associated immune responses may have, directly and/or indirectly, played a role in the pathogenesis of the Type 1 DM in this patient.

元の言語English
ページ(範囲)841-847
ページ数7
ジャーナルEndocrine Journal
63
発行部数9
DOI
出版物ステータスPublished - 2016

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Type 1 Diabetes Mellitus
Adenoma
T-Lymphocytes
B-Lymphocytes
Macrophages
Thirst
Ketosis
Pancreatectomy
Autoantibodies
Weight Loss
Pancreas
Lymphocytes
Insulin
Apoptosis
Staining and Labeling
Cytokines
Glucose
Neoplasms

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

これを引用

CD4+ T cell‒dominant insulitis in acute-onset type 1 diabetes mellitus associated with intraductal papillary mucinous adenoma. / Yajima, Ken; Oikawa, Yoichi; Ogata, Kentaro; Hashiguchi, Akinori; Shimada, Akira.

:: Endocrine Journal, 巻 63, 番号 9, 2016, p. 841-847.

研究成果: Article

Yajima, Ken ; Oikawa, Yoichi ; Ogata, Kentaro ; Hashiguchi, Akinori ; Shimada, Akira. / CD4+ T cell‒dominant insulitis in acute-onset type 1 diabetes mellitus associated with intraductal papillary mucinous adenoma. :: Endocrine Journal. 2016 ; 巻 63, 番号 9. pp. 841-847.
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