Examination of islets in the pancreas biopsy specimens from newly diagnosed Type 1 (insulin-dependent) diabetic patients (original) (raw)

Summary

We attempted to examine the immunopathological change of the pancreatic islets of newly diagnosed Type 1 (insulin-dependent) diabetic patients and thereby to obtain useful information for the therapy of the patients. For this purpose, pancreas biopsy under laparoscopy was performed 2–4 months after the onset of Type 1 diabetes in seven newly diagnosed patients. All biopsies were performed safely without any complications. Immunohistochemical examination of the biopsy specimens revealed a marked decrease of insulin-containing cells, preservation of glucagon-containing cells, and various degrees of expression of MHC class I and class II antigens in islet cells and in endothelial cells within and around the islets. Signs of active autoimmune phenomena, e. g. lymphocytic infiltration or immunoglobulin deposition in islets, were not detected in any of these patients by light microscopical evaluation. We conclude that pancreas biopsy under laparoscopy has shown various immunological changes in the islets of newly diagnosed Type 1 diabetic patients. Pancreas biopsy, however, may not be suitable under the present protocol for the selection of patients for immunotherapy because of problems including sampling errors.

Article PDF

Similar content being viewed by others

References

  1. Eisenbarth GS (1986) Type I diabetes mellitus, a chronic autoimmune disease. N Engl J Med 314: 1360–1368
    PubMed Google Scholar
  2. Bottazzo GF (1984) β-cell damage in diabetic-insulitis: are we approaching a solution? Diabetologia 26: 241–249
    Article PubMed Google Scholar
  3. Gepts W (1965) Pathological anatomy of the pancreas in juvenile diabetes. Diabetes 14: 619–633
    PubMed Google Scholar
  4. Junker K, Egeberg J, Kromann H, Nerup J (1977) An autopsy study of the islets of Langerhans in acute-onset juvenile diabetes mellitus. Acta Pathol Microbiol Scand Sect A 85: 699–706
    Google Scholar
  5. Doniach I, Morgan AG (1973) Islets of Langerhans in juvenile diabetes mellitus. Clin Endocrinol 2: 233–248
    Google Scholar
  6. Foulis AK, Liddle CN, Farquharson MA, Richmond JA, Weir RS (1986) The histopathology of the pancreas in Type 1 (insulin-dependent) diabetes mellitus: a 25-year review of deaths in patients under 20 years of age in the United Kingdom. Diabetologia 29: 267–274
    PubMed Google Scholar
  7. Bottazzo GF, Dean BM, McNally JM, MacKay EH, Swift PGF, Gamble DR (1985) In situ characterization of autoimmune phenomena and expression of HLA molecules in the pancreas in diabetic insulitis. N Engl J Med 313: 353–360
    PubMed Google Scholar
  8. Meyer-Burg J (1972) The inspection, palpation and biopsy for the pancreas. Endoscopy 4: 99–101
    Google Scholar
  9. Ishida H (1983) Peritoneoscopy and pancreas biopsy in the diagnosis of pancreatic diseases. Gastrointest Endosc 29: 211–218
    PubMed Google Scholar
  10. Foulis AK, Farquharson MA (1986) Aberrant expression of HLA-DR antigens by insulin-containing beta-cells in recentonset Type I diabetes mellitus. Diabetes 35: 1215–1224
    PubMed Google Scholar
  11. Foulis AK, Farquharson MA, Hardman R (1987) Aberrant expression of Class II major histocompatibility complex molecules by B cells and hyperexpression of Class I major histocompatibility complex molecules by insulin containing islets in Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 30: 333–343
    PubMed Google Scholar
  12. Bougneres PF, Carel JC, Castano L, Boitard C, Gardin JP, Landais P, Hors J, Mihatsch MJ, Pillard M, Chaussain JL, Bach JF (1988) Factors associated with early remission of Type I diabetes in children treated with cyclosporine. N Engl J Med 318: 663–670
    PubMed Google Scholar
  13. Bottazzo GF, Pujol-Borrell R, Hanafusa T, Feldmann M (1983) Role of aberrant HLA-DR expression and antigen presentation in the induction of endocrine autoimmunity. Lancet II: 1115–1118
    Article Google Scholar
  14. Hanafusa T, Pujol-Borrell R, Chiovato L, Russell RCG, Doniach D, Bottazzo GF (1983) Aberrant expression of HLA-DR antigen on thyrocytes in Graves' disease: relevance for autoimmunity. Lancet II: 1111–1115
    Article Google Scholar
  15. Jenson AB, Rosenberg HS (1984) Multiple viruses in diabetes mellitus. Prog Med Virol 29: 197–217
    PubMed Google Scholar

Download references

Author information

Authors and Affiliations

  1. The Second Department of Internal Medicine, Osaka University Medical School, Osaka
    T. Hanafusa, A. Miyazaki, J. Miyagawa, S. Tamura, M. Inada, H. Katsura, K. Yamagata, N. Itoh, H. Asakawa, C. Nakagawa, A. Otsuka, S. Kawata, N. Kono & S. Tarui
  2. Department of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine, Kurume
    K. Yamada
  3. Nishinomiya Prefectural Hospital, Nishinomiya, Hyogo, Japan
    Y. Shinji

Authors

  1. T. Hanafusa
    You can also search for this author inPubMed Google Scholar
  2. A. Miyazaki
    You can also search for this author inPubMed Google Scholar
  3. J. Miyagawa
    You can also search for this author inPubMed Google Scholar
  4. S. Tamura
    You can also search for this author inPubMed Google Scholar
  5. M. Inada
    You can also search for this author inPubMed Google Scholar
  6. K. Yamada
    You can also search for this author inPubMed Google Scholar
  7. Y. Shinji
    You can also search for this author inPubMed Google Scholar
  8. H. Katsura
    You can also search for this author inPubMed Google Scholar
  9. K. Yamagata
    You can also search for this author inPubMed Google Scholar
  10. N. Itoh
    You can also search for this author inPubMed Google Scholar
  11. H. Asakawa
    You can also search for this author inPubMed Google Scholar
  12. C. Nakagawa
    You can also search for this author inPubMed Google Scholar
  13. A. Otsuka
    You can also search for this author inPubMed Google Scholar
  14. S. Kawata
    You can also search for this author inPubMed Google Scholar
  15. N. Kono
    You can also search for this author inPubMed Google Scholar
  16. S. Tarui
    You can also search for this author inPubMed Google Scholar

Rights and permissions

About this article

Cite this article

Hanafusa, T., Miyazaki, A., Miyagawa, J. et al. Examination of islets in the pancreas biopsy specimens from newly diagnosed Type 1 (insulin-dependent) diabetic patients.Diabetologia 33, 105–111 (1990). https://doi.org/10.1007/BF00401048

Download citation

Key words