Originals

Diabetologia

, Volume 33, Issue 2, pp 105-111

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

  • T. HanafusaAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
  • , A. MiyazakiAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
  • , J. MiyagawaAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
  • , S. TamuraAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
  • , M. InadaAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
  • , K. YamadaAffiliated withDepartment of Medicine, Division of Endocrinology and Metabolism, Kurume University School of Medicine
  • , Y. ShinjiAffiliated withNishinomiya Prefectural Hospital
  • , H. KatsuraAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
  • , K. YamagataAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
    • , N. ItohAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
    • , H. AsakawaAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
    • , C. NakagawaAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
    • , A. OtsukaAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
    • , S. KawataAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
    • , N. KonoAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School
    • , S. TaruiAffiliated withThe Second Department of Internal Medicine, Osaka University Medical School

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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.

Key words

Type 1 (insulin-dependent) diabetes mellitus pathology pathogenesis diagnosis pancreas biopsy laparoscopy immunohistochemistry MHC class I antigen MHC class II antigen immunotherapy