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Augmentation of the immune response to islet cell antigens with

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  • claudine intexas
    Z Gastroenterol 1999 Mar;37(3):235-9 [Augmentation of the immune response to islet cell antigens with development of diabetes mellitus caused by
    Message 1 of 1 , Jan 1, 2001
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      Z Gastroenterol 1999 Mar;37(3):235-9

      [Augmentation of the immune response to islet cell
      antigens with
      development
      of
      diabetes mellitus caused by interferon-alpha therapy
      in chronic
      hepatitis
      C].

      [Article in German]

      Seifarth C, Benninger J, Bohm BO, Wiest-Ladenburger U,
      Hahn EG, Hensen
      J

      Medizinische Klinik I mit Poliklinik,
      Friedrich-Alexander-Universitat
      Erlangen.

      We report on a 36-year-old patient suffering from
      chronic hepatitis C.
      Because of elevated liver enzymes and histology
      showing chronic
      inflammation
      and periportal fibrosis, interferon-alpha (IFN)
      therapy was started
      with a
      dosage of 5 Mio units three times a week. Four months
      later the patient
      hat
      to be hospitalized due to the typical clinical
      features of a recent
      onset
      type 1 diabetes (BG > 300 mg/dl, HbA1c 9.6%,
      ketonuria). In serum
      samples
      prior to and following interferon therapy, we analyzed
      titers of
      diabetes-related autoantibodies responding to GAD65
      (glutamic acid
      decarboxylase), IA2c (tyrosine phosphatase) and ICA
      (islet cell
      autoantibodies). While ICA were negative before
      starting therapy,
      IA2c-antibodies were highly elevated. In contrast.
      GAD65-antibodies
      were
      elevated only slightly over the cut-off of the assay
      before therapy
      (controlled by a second different RIA assay) and
      increased 100 fold
      during
      IFN-alpha treatment. Additionally thyroid antibodies
      appeared. After
      the end
      of the IFN therapy, GAD65- and IA2c antibodies
      remained on high levels
      and
      also ICA could now be found. The patient was positive
      for HLA-DR4. This
      case
      supports the hypothesis that IFN-alpha therapy may
      lead to an augmented
      autoimmune reaction against islet cell antigens
      resulting in the
      development
      of diabetes mellitus type 1, especially if there are
      other predisposing
      factors before IFN treatment. We further discuss the
      possible
      involvement of
      interferon-alpha in the pathogenesis of autoimmune
      diabetes with
      reference
      to recent studies.

      PMID: 10234796, UI: 99251104


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