Type 1 diabetes mellitus (DM) is an autoimmune disease that results from the destruction of insulin-secreting pancreatic islet beta cells by autoreactive cells and their mediators.
The aim of this study was to analyze the expression of Fas receptors (CD95) on T and B lymphocytes from patients with type 1 DM and to assess the role of soluble Fas (s-Fas) in Fas mediated apoptosis of T and B lymphocytes, and to assess the role of glycemic control in renal and ocular complications.
This study was carried out on three groups:
Group I: consist of 16 patients with type 1 DM. Their age ranged from (11-18) years old with mean duration of illness 6 + 4 months.
Group II: consist of 16 patients with long standing type 1 DM, their age ranged from 10 ā 19 years old, with mean duration of illness 30 + 10 months.
Group III: consist of 16 healthy persons their age ranged from 10.5 ā 19.5 years old. Results can be summarized as follows:
The incidence of positive microalbuminuria as well as incidence of retinopathy were significantly higher in group II (long standing DM) than newly diagnosed case (group I). Microalbuminuric patients had significantly higher HbA1C than others.
Newly diagnosed cases (group I) as well as (group II) long standing DM type 1 had significantly higher percentage of T and B lymphocyte bearing Fas receptors (CD95) as compared to control group. Mean plasma level of s-Fas showed a significant increase in both DM groups as compared to control group.
There is no significant difference in the percentage of lymphocytes expressing CD95, and plasma s-Fas levels when compared microalbuminuric to normoalbuminuric patients. There was positive correlation between HbA1C and microalbuminuria in diabetic patients, there was positive correlation between HBA1C and % of lymphocyte expressing the Fas receptors (CD95). In both diabetic groups, positive correlation was found between HbA1C and s-Fas in DM type 1. Also, positive correlation was found between % of cells expressing CD95 and s-Fas.
In conclusion, the study of the possible role of apoptosis of autoreactive lymphocytes and its regulation, in the pathogenesis of type 1 DM may provide new therapeutic tools for the prevention of the disease. Further analysis, is necessary to finally settle this point, to elucidate the roles played by distinct immunological pathway in diabetes pathogenesis, this can lead to more effective and targeted therapies for the disease. Poor glycemic control is an essential initiating factor of defective apoptosis in type 1DM.