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Article
Abnormal Lymphocyte Subsets in Children with Type 1 Diabetes Mellitus

Authors: Majed Al-Jelawy ماجد الجيلاوي --- Nidhal Abdul Mohymen نضال عبد المهيمن --- Eman M. Saleh
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2008 Volume: 7 Issue: 1 Pages: 9-14
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

This study was designed to investigate the cellular changes of peripheral blood lymphocytes (PBL) in children with type 1 diabetes mellitus (T1DM) by determining the surface antigens (CD markers). Sixty T1DM patients who were newly diagnosed as type1diabetetics (duration of their illness is less than five months) were selected from the National Diabetes Center at Al-Mustansiriya University during the period May 2004 to October 2005. All the patients were treated with daily replacement doses of insulin. Their age ranged from (3-17) years. Fifty apparently healthy control subjects, matched with age (4-17) years and sex underwent the PBL phenotyping. Phenotyping of lymphocyte surface antigens was done by direct Immunoflurocent (IF) technique using mouse antihuman CD3, CD4, CD8, CD19 and CD56.T1DM patients showed a remarkable lowering in CD3+, CD8+, and CD56+ cells but the decrease in CD4+ cells percentage was not significant in patients in comparison to healthy controls. In contrast, a significant elevation of CD19+ cell percentage and CD4+: CD8+ ratio were observed in the patients.

Keywords

T1DM --- CD markers --- Immunophenotyping


Article
Activated Peripheral Blood Lymphocyte Subpopulation in Newly Diagnosed Type 1 Diabetes Mellitus Children

Author: Eman Mahdi Saleh
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 2 Pages: 112-120
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

SUMMARY:BACKGROUND:In Type 1 Diabetes Mellitus (T1DM), numerous changes in the cellular as well humoral immune response have been identified. However, it is not known whether both the CD4+ and CD8+ subpopulation or only one of these or CD19+contains increased numbers of activated cells.OBJECTIVE:The aim was to study the activated lymphocyte subpopulation by use of monoclonal antibodies to T-cell and B-cell antigens which is known to be expressed on activated cells.METHODS:A total of 60 T1DM patients who had newly onset of the disease (diagnosed was from one week up to five months) were included in the present study, all the patients were treated with daily replacement doses of insulin. Fifty apparently healthy control subjects underwent the PBL phenotyping. Phenotyping of surface antigens was done by direct Immunoflurocent (IFT) technique using mouse antihuman CD3, CD4, CD8, CD45RA, CD19, and activated markers CD45RO, DR-antigen and CD38.RESULTS:T1DM patients showed a remarkable lowering in CD3+, CD8+, and CD45RA+ cells (p<0.0001), but the decrease in CD4+ cells percentage was not significant. In contrast, a significant elevation of activation markers includes (CD45RO+, HLA-DR+ and CD38+ cells) were observed in patients in addition to a significant increase of CD19+ cell percentage and CD4+: CD8+ ratio in the patients.CONCLUSION:This study provides evidence that abnormalities of T-cells regulation are detectable in patients with T1DM.

Keywords

T1DM --- CD markers --- immunophenotyping


Article
Detection of GAD¬65 Antibodies in Newly Onset Type 1 Diabetic Children
الأجسام المضادة الذاتية ل (GAD) في الأطفال المصابين بداء السكري من النوع الأول

Authors: Eman M. Saleh ايمان مهدي صالح --- Nidhal abdul Mohymen
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2008 Volume: 21 Issue: 1 Pages: 75-78
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Summary:Back ground: Glutamic acid decarboxylase (GAD) has been defined as a major target antigen in type 1 diabetes mellitus (T1DM).Aim of the study: Assessment of GAD¬65 autoantibodies in the serum of T1DM children at onset of the disease.Patients & Methods: Serum GAD¬65 autoantibodies has been estimated in 60 sera samples of newly diagnosed T1DM children (diagnosed less than 5 months) in comparison with 50 healthy control children using IRMA method.Results & conclusion: A higher significant proportion of the patients were positive to GAD65 autoantibodies (50%) in comparisons with healthy controls (4.76%) in age group ≤10 years old and (6.90%) in > 10years old (p<0.0001), whereas a significant proportion of girls tested positive for GADA were in age group >10years old (p<0.05). We concluded that GADA are an excellent diagnostic marker for T1DM.Key wards: GAD autoantibodies, T1DM.

المخلص:تم تصميم هذه الدراسة لتحديد المستوى المصلي للأجسام المضادة الذاتية (GAD) في المرضى عند حدوث المرض.شملت الدراسة ستون (60) مريضاً حديثي الإصابة بمرض السكري النوع الأول (مشخصين بالإصابة خلال فترة أقل من خمسة أشهر)، حيث تم قياس المستويات المصلية للأجسام المضادة الذاتية(GAD) بطريقة التالق المناعي(IRMA) ومقارنتها مع عينة السيطرة المؤلفة من(50) شخص.اظهرت النتائج ان هناك ارتفاعا معنويا في نسبة المرضى الموجبين للاجسام المناعية الذاتية (50%) مقارنة مع مجموعة السيطرة(4.76%) في الاعمار اقل من 10 سنوات و (6.9%) في الاعمار اكثر من 10 سنوات (P<0.0001).بالاضافة الى ذلك فان النسبة الاكبر من المرضى الاناث الموجبة لفحص الاجسام المناعية من الاعمار الكبيرة,(P<0.05). وبالتالي فان ان هذا الفحص يعتبر من الفحوص التشخيصية المهمة لمرض السكر من النوع الاول.

Keywords

GAD autoantibodies --- T1DM.


Article
Genetic characteristics and β-cell Autoimmunity in T1DM Children

Author: Eman M. Saleh
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 4 Pages: 414-424
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: TIDM is known to be polygenic disease that appears from the interaction of mutation in multiple genes including HLA. The autoimmune mediated destruction of pancreatic β-cells is reflected by the presence of autoantibodies against prominent antigens in the pancreatic β-cells. Objective: This study was designed to investigate the role of HLA-class I and class II antigens in the etiology of type 1 diabetes mellitus (T1DM) and also assessment of glutamic acid decarboxylase (GAD65) autoantibodies in the patients at the onset of the disease. Patients & Methods: Sixty T1DM patients who were newly onset of the disease (diagnosed less than five months) were selected. Eighty apparently healthy control subjects, matched with age, sex and ethnic backgrounds underwent the HLA-typing by lymphocytotoxicity assay. Finally 50 healthy individuals were selected randomly to undergo serological assessment of GAD65 autoantibodies using IRMA method. Results & Conclusion: At HLA-class I region, T1DM patients showed a significant increased frequency of antigen A9 (40.0 vs.18.75%) and B8 (28.33 vs.8.75%) as compared to control subject. At HLA-class II region, DR3 and DR4 were significantly increased in patients (53.33 vs.26.25% and 50.0 vs. 12.5% respectively) as compared to controls. In addition to that, T1DM was significantly associated with DQ2 (33.33 vs.15%) and DQ3 (40.0 vs. 20%) antigens as compared to controls, suggesting that these haplotypes had a role in disease susceptibility, while the frequency of DR2 and DQ1 antigens were significantly lowered in patients compared to controls (6.66 vs. 25% and 6.66 vs. 22.5% respectively). These molecules might had protective effect. Anti-GAD65 autoantibodies were present in 50% of T1DM children especially in older ages and in females more than males. High proportion of GADA was found in the patients carrying HLA-DR3/DR4 heterozygous. In conclusion, susceptibility to T1DM is genetically controlled.


Article
The Evaluation of Serum IFN-γ and TGF-β in Some Patients with Type1 Diabetes mellitus in Al-diwanyah Province.

Author: Ghasoun M. Wadai
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2017 Volume: 16 Issue: 2 Pages: 67-73
Publisher: Baghdad University جامعة بغداد

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Abstract

The diabetes mellitus type one (T1DM) is considered as autoimmune disease due to the destruction of Langerhans beta cell, which is the insulin-producing cell as a result of the invasion by cells of the immune system with vital roles. There is evidence that interferone-γ IFN-γ is responsible for the T1DM disease developing, and so the transforming growth factor type beta ( TGF-β) was known as an important regulator of the immune response. Throughout of this study gain more understanding about the two cytokines role in this disease and the correlation between them to provide immunotherapeutic strategies for T1DM. A total of 35 with T1DM (19 female, 16 male), in addition to (15) healthy control subjects undertook the measurement of serum IFN-γ and TGF-β by ELISA technique. The result explains higher mean serum levels of IFN-γ (684.867 ± 246.23 pg/ml) were observed in the investigated patients compared to healthy control (11.75 ± 4.56 pg/ml). Whereas observed decline in the serum TGF-β (302.2± 65.43 pg/ml) as compared to healthy control (1153 ± 186.35 pg/ml) at the level (p<0.01), and so the result explained a significant negative correlation between TGF_β and INF_γ concentration (p<0.05). The conclusion is that T1DM patients were detected with a significantly increase in INF_γ and decrease TGF_β serum level, and they have the antagonistic effect on the T1DM development.

Keywords

IFN-γ --- TGF-β --- T1DM.


Article
Association between HLA-Class II Alleles and T-Cell Proliferation in Response to Enterovirus and Adenovirus

Author: Eman M. Saleh
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 2 Pages: 102-108
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BACK GROUND:Viruses may be involved in the pathogenesis of Type 1 Diabetes Mellitus (T1DM), either through direct β-cell infection or as triggers of autoimmunity.OBJECTIVE:To evaluate the T- cell proliferation in response to Enterovirus antigens including Coxsackievirus B and Poliovirus in addition to Adenovirus in an HLA- matched population of children with T1DM and children who were healthy.METHODS:A total of 60 Iraqi T1DM children were included in the presents study. They were new onset of the disease. For the purpose of comparisons, 50 apparently healthy control subjects were selected. HLA typing was measured by microlymphocytotoxicity, while methylthiazoltetrazolium (MTT) assay was used for lymphocyte proliferation by culturing peripheral blood lymphocytes (PBL) with Coxsackievirus B5, Adenovirus 3, 4, and 7, and Poliovaccin.RESULTS & CONCLUSION:No significant differences were shown in the PBL proliferative percentage in response to Con-A mitogen and tested viruses (CVB5 and Adenovirus) between T1DM and healthy controls, but PBL proliferative percentage of patients showed a significant decline in response to Poliovaccine. HLA class II (-DR3, DR4, DQ2 and DQ3) antigens were significantly increased in T1DM patients and they played an important role in the etiology of the disease. Strong T-cell proliferation in response to the tested viral antigens were observed to be related to HLA-DR4 and HLA-DQ3 antigens, whereas the HLA-DR3 and HLA-DQ2 alleles were associated with week responsiveness to the same antigens. However, in children with new- onset diabetes, responses were decreased and this could be caused by trapping of virus- specific T- cells in the pancreas


Article
ASSOCIATION BETWEEN HLA-CLASS II ALLELES AND T-CELL PROLIFERATION IN RESPONSE TO ENTEROVIRUSES AND ADENOVIRUS ANTIGENS IN NEWLY DIAGNOSED CHILDREN WITH TYPE 1 DIABETES MELLITUS
العلاقة بين مستضدات التطابق النسيجي- الصنف الثاني والفعالية الوظيفية للخلايا اللمفية بعد تحفيزها بمستضدات الحمات المعوية والحمات الغدية في الاطفال المصابين حديثاً بالسكري من النوع الأول

Author: ايمان مهدي صالح
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2010 Volume: 9 Issue: 2 Pages: 180-190
Publisher: Baghdad University جامعة بغداد

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Abstract

Viruses may be involved in the pathogenesis of Type 1 Diabetes Mellitus (T1DM), either through direct β-cell infection or as triggers of autoimmunity. T- cell proliferation was evaluated in response to Enteroviruses antigens including Coxsackievirus B and Poliovirus in addition to Adenovirus in an HLA- matched population of children with T1DM and in children who were apparently healthy. A total of 60 Iraqi T1DM children were included in the presents study. They were with new onset of the disease. For the purpose of comparisons, 50 apparently healthy control subjects were also selected. HLA typing was measured by microlymphocytotoxicity, while methylthiazoltetrazolium (MTT) assay was used for lymphocyte proliferation by culturing peripheral blood lymphocytes (PBL) with Coxsackievirus B5, Adenovirus 3, 4 and 7 and Poliovaccine. No significant differences were shown in the PBL proliferative percentage in response to Con-A mitogen and tested viruses (CVB5 and Adenovirus) between T1DM and healthy controls, but PBL proliferative percentage of patients showed a significant decline in response to Poliovaccine. HLA class II (-DR3, DR4, DQ2 and DQ3) antigens were significantly increased in T1DM patients and they played an important role in the etiology of the disease. Strong T-cell proliferation in response to the tested viral antigens were observed to be related to HLA-DR4 and HLA-DQ3 antigens, whereas the HLA-DR3 and HLA-DQ2 alleles were associated with week responsiveness to the same antigens. However, in children with new- onset diabetes, responses were decreased and this could be caused by trapping of virus- specific T- cells in the pancreas.

أثبتت العديد من الدراسات أن للفايروسات دوراً تؤديه في احداث امراضية مرض السكر من النوع الاول بالاصابة المباشرة لخلايا بيتا في البنكرياس أو بتحفيزالمناعه الذاتية. أجريت الدراسة لغرض تقييم الفعالية الوظيفية للخلايا اللمفية بعد تحفيزها بمستضدات الحمات المعوية والتي تشمل فايروس الكوكساكي نوع- ب وفايروس شلل الاطفال فضلا عن الحمة الغدية في مجموعة من الاطفال المصابين بمرض السكري من النوع الاول ومجموعة من الاطفال الاصحاء المطابقين لمستضدات التطابق النسيجي من الصنف الثاني. شملت الدراسة ستون مريضاً حديثي الاصابة بمرض السكري النوع الاول فضلا عن مجموعة السيطرة المكونة من 50 طفلا يبدون أصحاء ظاهريا لغرض التحري عن وجود أليلات الخطورة لمستضدات التطابق النسيجي- الصنف الثاني. تم قياس الفعالية الوظيفية للخلايا اللمفية بعد حضنها مع الفايروسات انفة الذكر. أظهرت النتائج انخفاضا غير معنويا في الفعالية الوظيفية للخلايا اللمفية كأستجابة للمشطر وكذلك بعد حضنها مع فايروس الكوكساكي النوع المصلي ب-5 وفايروس الحمة الغدية للانواع المصلية 3، 4, و 7 في الاطفال المرضى مقارنة بالاصحاء. ولكن هذا الانخفاض كان معنويا فقط عند استخدام فايروس شلل الاطفا ل .هناك زيادة معنوية في نسبة الاطفال الحاملين لاليلات الخطورة من الصنف الثاني مقارنة بالاصحاء HLA class II (-DR3, DR4, DQ2 and DQ3) antigens وهناك علاقة مباشرة وقوية بين الفعالية الوظيفية للخلايا اللمفية بعد حضنها مع المستضدات الفايروسية ومستضدات التطابق النسيجي , بينما كانت العلاقة ضعيفة مع المستضدات الاخرى HLA- DR4, HLA- DQ3HLA-DR; -DQ2. عموما كانت الاستجابة قليلة في الاطفال المرضى ولكن هناك زيادة محسوسة عند الاطفال الحاملين لاليلات التطابق النسيجي من النوع الثاني


Article
Asymptomatic Thyroid Disorders In Type 1 Insulin Dependent Diabetes Mellites of Childhood

Author: Jasim Mohammed Hashim
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2014 Volume: 11 Issue: 3 Pages: 606-612
Publisher: Babylon University جامعة بابل

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Abstract

Objective: The type 1 insulin dependent diabetes mellitus (T1DM) and thyroid dysfunctions are common endocrine disorder and each condition affect the others, The associations between these two conditions are well documented, (T1DM) patients are prone to thyroid disorders for different causes . we aim in this study to evaluate thyroid disorder among children with T1DM . Methods : A hospital based case control study conducted in the clinic of endocrine disorders in Alzahra Teaching Hospital for the period between 1st of May 2012 to 31th of January 2013. Fifty patients with type 1 insulin dependent diabetes mellitus (T1 IDDM) consists of group A. The control group (group B)consist of Fifty healthy children . Serum level of TSH,T3,T4 were measured by using Minividas for both groups . Results: Patients aged 5-11 years, Boys were 27 and girls 23 .The mean age of patients was 7.2±1.53 years. The Mean concentrations of TSH were 4.05 ± 1.98 mlU/L in the patients with type 1 diabetic and this is significantly higher than the control group 2.29±0.87 mlU/L with Statistically significant difference (p <0.008). Whereas mean concentrations of TT3 were 1.82 ± 0.35mlU/L in group A and 2.16±0.43 mlU/L in group B this result is significantly lower than the control group with Statistically significant difference (p <0.01) .while there was no significant difference in TT4 values between the type 1 diabetic patients 103.38±8.4 mlU/L and control group 109.70±6.72 mlU/L with(p=0.15)Conclusion: This study shows Thyroid disorder is common in type 1 diabetic children. Periodic estimation of TSH and a lesser degree TT3 is important for early detection of thyroid disorder in T1DM patients before appearance of any clinical signs of thyroid disease.

خلفية البحث : داء السكري عند الأطفال ( من النوع الأول و المعتمد على الأنسولين ) واضطرابا ت الغدة الدرقية من أمراض الغدد الصماء الشائعة وكلاهما يؤثر على الأخر والعلاقة بينهما موثقة بشكل كبير , مرضى داء السكري معرضون إلى اضطرابات الغدة الدرقية لعدة أسباب .هدف البحث: سيتم في هذا البحث تقييم فحص وظائف الغدة الدرقية لدى مرضى داء السكري( من النوع الأول و المعتمد على الأنسولين ).طرق البحث :تم إجراء دراسة (من نمط الحالات والشواهد) في عيادة أمراض الغدد الصماء في مستشفى الزهراء التعليمي للفترة من الأول من أيار 2012 ولغاية نهاية كانون الثاني 2013 . شملت الدراسة 50 مريض (مصابا بداء السكري من النوع الأول و المعتمد على الأنسولين ) وقد مثلوا المجموعة ( أ ) . ضمت ل المجموعة الضابطة 50 طفلا من الأصحاء مثلوا المجموعة( ب), تم تحديد تراكيز هرمونات الغدة الدرقية((T3,T4 وكذلك هرمون الغدة النخامية المحفز للغدة الدرقية (( TSHفي مصل الدم بواسطة جهاز Minividas لدى كلتا المجموعتينالنتائج : تراوحت أعمار المرضى بين 4 و15 سنة , المعدل العمري للمرضى كان 7.2±1.53 سنة ,منهم (27) ذكرا, (23) أنثى . أظهرت الدراسة ارتفاع متوسط تركيز هرمون TSH في مصل الدم لدى المجموعة (أ ) 4.05 ± 1.98 mlU/L) ) وهو أعلى مقارنة بالمجموعة (ب ) 2.29±0.87 mlU/L)). وكانت النتائج ذات معنوية احصائية هامة بقيمة اقل (p <0.008) بلغ متوسط تركيز هرمون T3 في مصل الدم للمجموعة (أ ) ( 1.82 ± 0.35mlU/L) وهو أقل مقارنة بالمجموعة (ب ) 2.16±0.43 mlU/L)) وكانت النتائج ذات معنوية احصائية هامة بقيمة اقل ((p<0.0. لم تظهر الدراسة وجود علاقة احصائية هامة بين متوسط تركيز هرمون T4 بين المجموعتين (p=0.15). حيث كانت نتائج متوسط تركيز هرمونT4 103.38±8.4 mlU/L)) و109.70±6.72 mlU/L للمجموعتين(أ ) و(ب ) على التوالي.الاستنتاجات : اضطرابات الغدة الدرقية كثيرة الحدوث بين مرضى داء السكري من النوع الأول المعتمد على الأنسولين التوصيات: يجب التركيز على الفحص الدوري لتركيز هرمون TSH وبدرجة اقل تركيز هرمون T3 لدى هؤلاء المرضى لتحديد تلك الاضطرابات قبل ظهور الأعراض السريرية.


Article
Interleukin-2 and Interleukin-12 levels of Type 1 Diabetes Mellitus Patients inThi-qar Province
مستويات انترلوكين2 وانترلوكين 12 لمرضى داء السكري النوع الاول في محافظة ذي قار

Authors: Ali Naeem Salman علي نعيم سلمان --- MaythamTalibQasim ميثم طالب قاسم
Journal: Journal of Education for Pure Science مجلة التربية للعلوم الصرفة ISSN: 20736592 Year: 2016 Volume: 6 Issue: 1 Pages: 93-104
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

أجريت الدراسة الحالية في مركز السكري والغدد الصماء في مديرية الصحة في محافظة ذي قار، خلال الفترة من تشرين الاول 2013 إلى ايار 2014. هدفتالدراسة الى تقييم الحالة المناعية لمرضى السكري من النوع الأول عن طريق قياس مستويات الحركيات الخلوية ، التي شملت (IL-2، IL-12) في مصل الدم باستخدام تقنية الإمتزاز المناعي المرتبط بالإنزيم (ELISA) , شملت الدراسة دراسة 72 فردا من المرضى الذين يعانون من داء السكري من النوع الأول (37 ذكور و 35 إناث) تراوحت أعمارهم بين 1-40سنة. بالمقارنة مع 12 شخصا من الأصحاء ظاهريا. وأظهرت النتائج زيادة معنوية (P ≤ 0.01) في مستويات الحركيات الخلوية في المصل (IL-2، IL-12) في جميع المرضى الذين يعانون من داء السكري من النوع الأول مقارنة مع مجموعة السيطرة.

Keywords

IL-2 --- IL-12 --- T1DM --- Thi-Qar


Article
Human Leukocyte Antigens class II influence the expression of Glutamic Acid Decarboxylase auto antibodies in Type Diabetic children and their Siblings

Author: Eman Mahdi Saleh ايمان مهدي صالح
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2010 Volume: 6 Issue: 1 Pages: 52-61
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The immunogenetic predisposition may be considered as an important factor for the development of Type 1 Diabetes Mellitus (T1DM) in association with the HLA antigens. Objective:This study was designed to investigate the role of HLA-class II antigens in the etiology of type T1DM and in prediction of this disease in siblings, and its effect on expression of glutamic acid decarboxylase autoantibodies (GADA). methods:Sixty children who were newly diagnosed type 1 diabetes (diagnosed less than five months) were selected. Their age ranged from 3-17 years. Another 50 healthy siblings were available for this study, their ages range from 3-16 years. Eighty apparently healthy control subjects, matched with age (4-17) years, sex and ethnic backgrounds (Iraqi Arabs) underwent the HLA-typing examination. Finally 50 healthy individuals were selected randomly to undergo GADA test.Results:At HLA-class II region, DR3 and DR4 were significantly increased in patients (53.33 vs.26.25% and 50.0 vs. 12.5% respectively) as compared to controls. In addition to that, T1DM was significantly associatedwith DQ2 (33.33 vs.15%) and DQ3 (40.0 vs.20%) antigens as compared to controls, suggesting that these antigens had a role in disease susceptibility, while the frequency of DR2 and DQ1 antigens were significantly lowered in patients compared to controls (6.66 vs.25% and 6.66 vs.22.5% respectively). These molecules might have protective effect. In siblings a significant increase frequency of DR4 antigen (34.0 vs.12.5%) was observed in comparison to controls, suggesting that it might be much useful for predicting T1DM in affected families.Anti-GAD autoantibodies were present in 50% of Type 1Diabetic children, and in 16% of their siblings. High proportion of GADA was found in the patients carrying HLA-DR3/DR4 heterozygous.conclusion:Both the T1DM patients and their siblings shared the HLA- DQ1 as protective antigens, while DR3 and DR4 were susceptible one, and high proportion of GADA was found in the T1DM patients and siblings carrying HLA-DR3/DR4 heterozygous.

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