Summary
The distribution and volume of the pancreatic endocrine cells were studied in a case of type 1 diabetes with a duration of approximately 7 days. Immunocytochemical techniques combined with morphometry were used. The PP-cell rich lobe, making up about 10% of the total pancreatic volume, was not included in this study. The volume density and the absolute volume of the B-cells was found to be reduced to about one third to one seventh of the values determined in four controls of similar age and/or pancreatic volume. The A-cell volume was also diminished whereas the D- and PP-cell volume remained constant. As B-cell necroses could not be detected and insulitis was in the initial stages of development it is concluded that the destruction of B-cells proceeds slowly in type 1 diabetes. In the majority of cases it probably starts years before the clinical onset of the disease.
Similar content being viewed by others
References
Ahmad A, Abraham AA (1982) Pancreatic isleitis with coxsackie virus B 5 infection. Hum Pathol 13:661–662
Champsaur H, Dussaix E, Samolyk D, Fabre M, Bach C, Assan R (1980) Diabetes and coxsackie B 5 infection. Lancet 1:251
LeCompte PM (1958) “Insulitis” in early juvenile diabetes. Arch Pathol 66:450–457
Crossley JR, James AG, Elliott RB, Berryman CC, Edgar BW (1981) Residual B-cell function and islet cell antibodies in diabetic children. Pediatr Res 15:62–65
Cudworth AG (1978) Type 1 diabetes mellitus. Diabetologia 14:281–291
David H, Hartley HO, Pearson ES (1954) The distribution of the ratio, in a single normal sample, of range to standard deviation. Biometrika 11:482
Gepts W (1965) Pathologic anatomy of the pancreas in juvenile diabetes mellitus. Diabetes 14:619–633
Gepts W, DeMey J (1978) Islet cell survival determined by morphology. An immunocytochemical study of the islets of Langerhans in juvenile diabetes mellitus. Diabetes 27:(Suppl 1):251–261
Gorsuch AN, Lister J, Dean BM, Spencer KM, McNally JM, Bottazzo GF, Cudworth AG (1981) Evidence for a long prediabetic period in type 1 (insulin-dependent) diabetes mellitus. 11 Lancet 19/26:1363–1365
Gorsuch AN, Spencer KM, Lister J, Wolf E, Bottazzo GF, Cudworth AG (1982) Can future type 1 diabetes be predicted? A study in families of affected children. Diabetes 31:862–866
Klöppel G, Drenck CR (1983) Immunzytochemische Morphometrie beim Typ-1- und Typ-II-Diabetes mellitus. Dtsch Med Wochenschr 108:188–189
Madsbad S (1983) Prevalence of residual B cell function and its metabolic consequences in type 1 (insulin-dependent) diabetes. Diabetologia 24:141–147
Malaisse-Lagae F, Stefan Y, Cox J, Perrelet A, Orci L (1979) Identification of a lobe in the adult human pancreas rich in pancreatic polypeptide. Diabetologia 17:361–365
Oberholzer M (1983) Morphometrie in der klinischen Pathologie. Allgemeine Grundlagen. Springer, Berlin Heidelberg New York Tokyo
Rahier J, Wallon J, Henquin JC (1981) Cell populations in the endocrine pancreas of human neonates and infants. Diabetologia 20:540–546
Rahier J, Goebbels RM, Henquin JC (1983) Cellular composition of the human diabetic pancreas. Diabetologia 24:366–371
Rahier J, Wallon J, Loozen S, Lefevre A, Gepts W, Haot J (1983) The pancreatic polypeptide cells in the human pancreas: The effect of age and of diabetes. J Clin Endocrinol Metab 56:441–444
Sachs L (1978) Angewandte Statistik. Statistische Methoden und ihre Anwendungen. 5. Auflage. Springer, Berlin Heidelberg New York
Stefan Y, Orci L, Malaisse-Lagae F, Perrelet A, Patel Y, Unger RH (1982) Quantitation of endocrine cell content in the pancreas of nondiabetic and diabetic humans. Diabetes 431:694–700
Weibel ER (1979) Stereological methods. Practical methods for biological morphometry, vol. 1. Academic Press, London New York Toronto Sydney San Francisco
Yoon JW, Austin M, Onodera T, Notkins AL (1979) Virusinduced diabetes mellitus. Isolation of a virus from the pancreas of a child with diabetic ketoacidosis. New Engl J Med 300:1173–1179
Author information
Authors and Affiliations
Additional information
Dedicated to Prof. Dr. J. Kracht in honour of his sixtieth birthday
Supported by Deutsche Forschungsgemeinschaft, SFB 34, Hamburg
Rights and permissions
About this article
Cite this article
Klöppel, G., Drenck, C.R., Oberholzer, M. et al. Morphometric evidence for a striking B-cell reduction at the clinical onset of type 1 diabetes. Vichows Archiv A Pathol Anat 403, 441–452 (1984). https://doi.org/10.1007/BF00737292
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00737292