糖尿病自身抗体临床意义ppt课件.ppt

* Insulin was the 1st autoantigen to be defined in type 1 DM patients. Insulin is a dimeric protein with a 21 amino acid A chain, and a 30 amino acid B chain joined by two disulphide bonds. The physiological functions of this 6kD protein are well known, and include glucose uptake into the cell, glycolysis, glycogenesis, adipogenesis, and gluconeogenesis. Insulin was the 1st peptide hormone sequenced and defined by crystallography, and was used for the 1st licensed medication engineered genetically. * * * KB Mai 2010; Quelle： Eisenbarth, 2008, Natural History of Type 1 Diabetes Znt8 is characterized as one of the primarily used four antibodies to predict the development of T1DM. Zinc cation efflux transporter [zink kat-aien] – Zink-Kation-Ablu?-Transporter （Scl30A8） This transporter was discovered as an autoantigen, it is specifically expressed in islet beta-cells, where it is associated with the regulated pathway of insulin secretion. Znt8 facilitates the transportation of Zn2+ from the cytoplasm into the insulin secretory granule and the concentration of Zn2+ within the granule lumen where the zinc cation binds to insulin hexamers. Fluid phase radioassays have already been validated for autoantibodies to this antigen in the most recent CDC affiliated DASP workshop and approximately 60% of new onset patients have autoantibodies reacting with the zinc transporter. Insulin autoantibodies develop within weeks of the starting of subcutaneous injection of insulin, thus, after insulin therapy measurement of insulin autoantibodies is not useful. Assays for each of the above 3 autoantibodies can be set at 99th percentile of controls and approximately 90%of children with now onset diabetes express either one of the other autoantibody. 1型糖尿病：在无症状期及发病后一定时期中，可检出针对胰岛β细胞的自身抗体 因此，确认免疫介导1型糖尿病，主要依赖在糖尿病患者中检出针对胰岛β细胞各种抗原的自身免疫抗体 Since islet destruction is thought to be caused by an abnormal regulation of cellular immunity, the humoral responses against islets are not believed to co