Share This Article:

The Predictive Value of Biopsy of the Pancreas and Its Therapeutic Impact in Autoimmune Diabetes

Full-Text HTML XML Download Download as PDF (Size:5002KB) PP. 297-303
DOI: 10.4236/jdm.2014.44041    4,459 Downloads   4,875 Views  

ABSTRACT

Diabetes Mellitus is by definition an end-stage organ failure. Type 1 diabetes mellitus (T1DM) is an autoimmune disease. Auto-inflammatory infiltrate appears to characterize the insulitis associated with T2DM. Recently, in 2013, Eva Corpos and colleagues described a comprehensive composition of peri-islet capsules and their basement membrane (BM). Virtanen I, Otonkoski T and Irving-Rodgers H.F. have reported similar descriptions few years earlier which have not been taken seriously as they deserve. Bluestone JA, Virtanen I and Irving-Rodgers H.F. and other colleagues reported that accumulation of the lymphocytes around the islets without invasion of the BM is the first step in disease induction (non-destructive insulitis phase). Invasion of the BM byleucocytic infiltration (destructive insulitis phase) occurs over a period of several years offering a good window for therapeutic intervention. Clinical symptoms appear only when 70% - 90% of β-cell mass are destroyed. This data emphasize the importance of identification and classification of such pathologic features by performing a biopsy of the pancreas with histoimmunochemistry analysis at the pre-hyperglycemic stage in a high risk genetically predisposed autoimmune suspected patient which may at least in part help to achieve new therapeutic approaches and help in halting the progression to end stage pancreatic disease (ESPD) known as diabetes mellitus. In this review we are going to emphasize the predictive role biopsy of the pancreas can build up a solid gold standard tool in diagnosis, stage and therapeutically follow up autoimmune diabetes mellitus.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Nassar, W. and Mostafa, M. (2014) The Predictive Value of Biopsy of the Pancreas and Its Therapeutic Impact in Autoimmune Diabetes. Journal of Diabetes Mellitus, 4, 297-303. doi: 10.4236/jdm.2014.44041.

References

[1] Donath, M.Y. and Shoelson, S.E. (2011) Type 2 Diabetes as an Inflammatory Disease. Nature Reviews Immunology, 11, 98-107. http://dx.doi.org/10.1038/nri2925
[2] Brooks-Worrell, B. and Palmer, J.P. (2011) Is Diabetes Mellitus a Continuous Spectrum? Clinical Chemistry, 57, 158-161. http://dx.doi.org/10.1373/clinchem.2010.148270
[3] Brooks-Worrell, B.M., Reichow, J.L., Goel, A., Ismail, H. and Palmer, J.P. (2011) Identification of Autoantibody-Negative Autoimmune Type 2 Diabetic Patients. Diabetes Care, 34, 168-173.
http://dx.doi.org/10.2337/dc10-0579
[4] Eisenbarth, G.S. (2010) Banting Lecture 2009: An Unfinished Journey: Molecular Pathogenesis to Prevention of Type 1A Diabetes. Diabetes, 59, 759-774. http://dx.doi.org/10.2337/db09-1855
[5] Zhang, L. and Eisenbarth, G.S. (2011) Prediction and Prevention of Type 1 Diabetes Mellitus. Journal of Diabetes, 3, 48-53. http://dx.doi.org/10.1111/j.1753-0407.2010.00102.x
[6] Zhang, X.M., Wang, H.Y., Luo, Y.Y. and Ji, L.N. (2009) HLA-DQ, DR Allele Polymorphism of Type 1 Diabetes in the Chinese Population: A Meta-Analysis. Chinese Medical Journal, 122, 980-986.
[7] Ziegler, A.-G., Hummel, M., Schenker, M. and Bonifacio, E. (1999) Autoantibody Appearance and Risk for Development of Childhood Diabetes in Offspring of Parents with Type 1 Diabetes. The 2-Year Analysis of the German BabyDIAB Study. Diabetes, 48, 460-468.
http://dx.doi.org/10.2337/diabetes.48.3.460
[8] Barker, J.M., Barriga, K., Yu, L., et al. (2004) Prediction of Autoantibody Positivity and Progression to Type 1 Diabetes: Diabetes Autoimmunity Study in the Young (DAISY). The Journal of Clinical Endocrinology Metabolism, 89, 3896-3902. http://dx.doi.org/10.1210/jc.2003-031887
[9] Bottazzo, G.F., Florin-Christensen, A. and Doniach, D. (1974) Isletcell Antibodies in Diabetes Mellitus with Autoimmune Polyendocrine Deficiencies. Lancet, 2, 1279-1283.
http://dx.doi.org/10.1016/S0140-6736(74)90140-8
[10] Verge, C.F., Gianani, R., Kawasaki, E., et al. (1996) Prediction of Type I Diabetes in First-Degree Relatives Using a Combination of Insulin, GAD, and ICA512bdc/IA-2 Autoantibodies. Diabetes, 45, 926-933. http://dx.doi.org/10.2337/diab.45.7.926
[11] Orban, T., Sosenko, J.M., Cuthbertson, D., et al. (2009) Pancreatic Islet Autoantibodies as Predictors of Type 1 Diabetes in the Diabetes Prevention Trial-Type 1 (DPT-1). Diabetes Care, 32, 2269-2274.
http://dx.doi.org/10.2337/dc09-0934
[12] Yu, L., Robles, D.T., Abiru, N., Kaur, P., Rewers, M., Kelemen, K. and Eisenbarth, G.S. (2000) Early Expression of Antiinsulin Autoantibodies of Humans and the NOD Mouse: Evidence for Early Determination of Subsequent Diabetes. Proceedings of the National Academy of Sciences of the United States of America, 97, 1701-1706. http://dx.doi.org/10.1073/pnas.040556697
[13] van Belle T.L., Coppieters, K.T. and von Herrath, M.G. (2011) Type 1 Diabetes: Etiology, Immunology and Therapeutic Strategies. Physiological Reviews, 91, 79-118.
http://dx.doi.org/10.1152/physrev.00003.2010
[14] Langerhans, P. (1869) Beitragezurmikroscopischenanatomie der bauchspeichel druse. Inaugural-Dissertation, Gustav Lange, Berlin.
[15] Feldman, M., Friedman, L.S., Brandt, L.J. and Marvin, H. (2009) Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th Edition, MD Consult, St. Louis.
[16] Pérez-Armendariz, M., Roy, C., Spray, D.C. and Bennett, M.V. (1991) Biophysical Properties of Gap Junctions between Freshly Dispersed Pairs of Mouse Pancreayic Beta Cells. Biophysical Journal, 59, 76-92. http://dx.doi.org/10.1016/S0006-3495(91)82200-7
[17] Yurchenco, P.D. and Patton, B.L. (2009) Developmental and Pathogenic Mechanisms of Basement Membrane Assembly. Current Pharmaceutical Design, 15, 1277-1294.
http://dx.doi.org/10.2174/138161209787846766
[18] Pinkse, G.G.M., Bouwman, W.P., Jiawan-Lalai, R., Terpstra, O.T., Bruijn, J.A. and de Heer, E. (2006) Integrin Signaling via RGD Peptides and Anti-β1 Antibodies Confers Resistance to Apoptosis in Islets of Langerhans. Diabetes, 55, 312-317. http://dx.doi.org/10.2337/diabetes.55.02.06.db04-0195
[19] Jones, P.L. and Jones, F.S. (2000) Tenascin-C in Development and Disease: Gene Regulation and Cell Function. Matrix Biology, 19, 581-596. http://dx.doi.org/10.1016/S0945-053X(00)00106-2
[20] Bluestone, J.A., Herold, K. and Eisenbarth, G. (2010) Genetics, Pathogenesis and Clinical Interventions in Type 1 Diabetes. Nature, 464, 1293-1300. http://dx.doi.org/10.1038/nature08933
[21] van Deijnen, J.H., Hulstaert, C.E., Wolters, G.H. and van Schilfgaarde, R. (1992) Significance of the Peri-Insular Extracellular Matrix for Islet Isolation from the Pancreas of Rat, Dog, Pig and Man. Cell and Tissue Research, 267, 139-146. http://dx.doi.org/10.1007/BF00318700
[22] Geutskens, S.B., Homo-Delarche, F., Pleau, J.M., Durant, S., Drexhage, H.A. and Savino, W. (2004) Extracellular Matrix Distribution and Islet Morphology in the Early Postnatal Pancreas: Anomalies in the Nonobese Diabetic Mouse. Cell and Tissue Research, 318, 579-588.
http://dx.doi.org/10.1007/s00441-004-0989-0
[23] Virtanen, I., Banerjee, M., Palgi, J., et al. (2008) Blood Vessels of Human Islets of Langerhans Are Surrounded by a Double Basement Membrane. Diabetologia, 51, 1181-1191.
http://dx.doi.org/10.1007/s00125-008-0997-9
[24] Korpos, E., Kadri, N., Kappelhoff, R., et al. (2013) The Peri-Islet Basement Membrane, a Barrier to Infiltrating Leukocytes in Type 1 Diabetes in Mouse and Human. Diabetes, 62, 531-542.
http://dx.doi.org/10.2337/db12-0432
[25] Otonkoski, T., Banerjee, M., Korsgren, O., Thornell, L.E. and Virtanen, I. (2008) Unique Basement Membrane Structure of Human Pancreatic Islets: Implications for Beta-Cell Growth and Differentiation. Diabetes, Obesity and Metabolism, 10, 119-127. http://dx.doi.org/10.1111/j.1463-1326.2008.00955.x
[26] Irving-Rodgers, H.F., Ziolkowski, A.F., Parish, C.R., Sado, Y., Ninomiya, Y., Simeonovic, C.J. and Rodgers, R.J. (2008) Molecular Composition of the Peri-Islet Basement Membrane in NOD Mice: A Barrier against Destructive Insulitis. Diabetologia, 51, 1680-1688. http://dx.doi.org/10.1007/s00125-008-1085-x
[27] Valli, M.B., Serafino, A., Crema, A., et al. (2006) Transmission in Vitro of Hepatitis C Virus from Persistently Infected Human B-Cells to Hepatoma Cells by Cell-to-Cell Contact. Journal of Medical Virology, 78, 192-201. http://dx.doi.org/10.1002/jmv.20527
[28] Wang, R.N., Paraskevas, S. and Rosenberg, L. (1999) Characterization of Integrin Expression in Islets Isolated from Hamster, Canine, Porcine and Human Pancreas. Journal of Histochemistry Cytochemistry, 47, 499-506. http://dx.doi.org/10.1177/002215549904700408
[29] Parish, C.R. (2006) The Role of Heparan Sulphate in Inflammation. Nature Reviews Immunology, 6, 633-643. http://dx.doi.org/10.1038/nri1918
[30] Ishida, H. (1983) Peritoneoscopy and Pancreas Biopsy in the Diagnosis of Pancreatic Diseases. Gastrointestinal Endoscopy, 29, 211-218. http://dx.doi.org/10.1016/S0016-5107(83)72587-3
[31] Imagawa, A., Hanafusa, T., Tamura, S., Moriwaki, M., Itoh, N., Yamamoto, K., Iwahashi, H., Yamagata, K., Waguri, M., Nanmo, T., Uno, S., Nakajima, H., Namba, M., Kawata, S., Miyagawa, J. and Matsuzawa, Y. (2001) Pancreatic Biopsy as a Procedure for Detecting in Situ Autoimmune Phenomena in Type 1 Diabetes. Close Correlation between Serological Markers and Histological Evidence of Cellular Autoimmunity. Diabetes, 50, 1269-1273.
http://dx.doi.org/10.2337/diabetes.50.6.1269
[32] Itoh, N., Hanafusa, T., Miyazaki, A., Miyagawa, J., Yamagata, K., Yamamoto, K., Waguri, M., Imagawa, A., Tamura, S., Inada, M., Tarui, S., Kono, N. and Matsuzawa, Y. (1993) Mononuclear Cell Infiltration and Its Relation to the Expression of Major Histocompatibility Complex Antigens and Adhesion Molecules in Pancreas Biopsy Specimens from Newly Diagnosed Insulin-Dependent Diabetes Mellitus Patients. Journal of Clinical Investigation, 92, 2313-2322. http://dx.doi.org/10.1172/JCI116835
[33] Imagawa, A., Hanafusa, T., Miyagawa, J., Matsuzawa, Y., for the Osaka IDDM Study Group (2000) A Novel Subtype of Type 1 Diabetes Mellitus Characterized by a Rapid Onset and an Absence of Diabetes-Related Antibodies. The New England Journal of Medicine, 342, 301-307.
http://dx.doi.org/10.1056/NEJM200002033420501
[34] Imagawa, A., Hanafusa, T., Itoh, N., Waguri, M., Yamamoto, K., Miyagawa, J., Moriwaki, M., Yamagata, K., Iwahashi, H., Sada, M., Tsuji, T., Tamura, S., Kawata, S., Kuwajima, M., Nakajima, H., Namba, M. and Matsuzawa, Y. (1999) Immunological Abnormalities in Islets at Diagnosis Paralleled Further Deterioration of Glycaemic Control in Patients with Recent-Onset Type I (Insulin-Dependent) Diabetes Mellitus. Diabetologia, 42, 574-578. http://dx.doi.org/10.1007/s001250051197
[35] The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1997) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, Diabetes Care, 20, 1183-1197.
[36] Imagawa, A., Hanafusa, T., Miyagawa, J. and Matsuzawa, Y. (2000) A Proposal of Three Distinct Subtypes of Type 1 Diabetes Mellitus Based on Clinical and Pathological Evidence. Annals of Medicine, 32, 539-543. http://dx.doi.org/10.3109/07853890008998833
[37] Papaccio, G., Latronico, M.V., Pisanti, F.A., Federlin, K. and Linn, T. (1998) Adhesion Molecules and Microvascular Changes in the Nonobese Diabetic (NOD) Mouse Pancreas. An NO-Inhibitor (L-NAME) Is Unable to Block Adhesion Inflammation-Induced Activation. Autoimmunity, 27, 65-77.
http://dx.doi.org/10.3109/08916939809008037
[38] Papaccio, G., Pisanti, F.A., Montefiano, R.D., Graziano, A. and Latronico, M.V. (2002) Th1 and Th2 Cytokines Exert Regulatory Effects upon Islet Microvascular Areas in the NOD Mouse. Journal of Cellular Biochemistry, 86, 651-664. http://dx.doi.org/10.1002/jcb.10250
[39] Yadav, R., Larbi, K.Y., Young, R.E. and Nourshargh, S. (2003) Migration of Leukocytes through the Vessel Wall and Beyond. Thrombosis and Haemostasis, 90, 598-606.
[40] Barsoum, R.S. (2007) Hepatitis C Virus: From Entry to Renal Injury—Facts and Potentials. Nephrology Dialysis Transplantation, 22, 1840-1848. http://dx.doi.org/10.1093/ndt/gfm205
[41] Masciopinto, F., Giovani, C., Campagnoli, S., et al. (2004) Association of Hepatitis C Virus Envelope Proteins with Exosomes. European Journal of Immunology, 34, 2834-2842.
http://dx.doi.org/10.1002/eji.200424887
[42] Ondr, J.K. and Pham, C.T. (2004) Characterization of Murine Cathepsin W and Its Role in Cell-Mediated Cytotoxicity. The Journal of Biological Chemistry, 279, 27525-27533.
http://dx.doi.org/10.1074/jbc.M400304200
[43] Hsing, L.C., Kirk, E.A., McMillen, T.S., et al. (2010) Roles for Cathepsins S, L, and B in Insulitis and Diabetes in the NOD Mouse. Journal of Autoimmunity, 34, 96-104.
http://dx.doi.org/10.1016/j.jaut.2009.07.003

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.