ROLE OF IMMUNE FACTORS IN THE EVOLUTION OF SLOWLY PROGRESSING AUTOIMMUNE DIABETES OF ADULTS (LADA)

Aim. To detect changes in parameters of cellular and humoral immunity in slowly progressing autoimmune diabetes of adults (LADA) patients and to define their role in the evolution of this form of the disease. Material and Methods. The study included 96 patients (39 men and 57 women, average age 48,64±10,03 years old),diagnosed with slowly progressing autoimmune diabetes of adults (LADA) according to the clinical and immunological data.. The disease duration ranged from 0.5 to 6.5 years (3,53±0,18). The determination of immune cells (CD3+-T-lymphocytes, CD4+-Thelper cells, CD8+-T suppressor/cytotoxic lymphocytes, CD16+- T-natural killer cells. CD20+-B lymphocytes with calculation immunoregulatory index IRI=CD4+/CD8+), and as the level of interleukins (IL-2, IL-4, IL-8, IL-10) and tumor necrosis factor- α (TNF-α) was conducted. Results and Discussions. In patients with progressing autoimmune diabetes without any divergence in the general lymphocytes quantity, a reliable decline of relative amount of CD3+-T-mature lymphocytes was determined. It may be a sign of a disturbance of their differentiation and ripening and/or a progressive apoptosis due to the increase of functional activity of this subpopulation. A probable decrease in the content of ÑD8+-T suppressor/cytotoxic lymphocytes compared to control was revealed. The latter reflects inhibition of supressive mechanisms, that it is also confirmed by an increase to ???. Reduction of the number of ÑD8+-T suppressor/cytotoxic lymphocytes might be due to their proven involvement in the development of local autoimmune inflammation (insulitis) and to their partial migration to the Langerhans' islets. An increased level of ?R? represents the relative activation of the helping link of cellular immunity. A probable reduction of CD16+-T-natural killer cells is associated with their specific involvement in reducing β-cell function with the development the of insulin dependence. The established high content of CD20+-B-lymphocytes in patients with slowly progressing autoimmune diabetes of adults is determined by the active production of antibodies. Significant differences in interleukin (IL-4, IL-8, IL-10) and TNF-α in patients with slowly progressing autoimmune diabetes of adults compared with controls with increasing both proinflammatory (IL-2, IL-8, TNF-α) as well as antiinflammatory cytokines (IL-4, IL10) were indentified. Conclusion. The results testify the involvement of cellular and humoral immunity disorders in the manifestation and evolution of slowly progressing autoimmune diabetes of adults (LADA). Key words: slowly progressing autoimmune diabetes of adults (LADA), T- and B- lymphocytes, interleukins, tumor necrosis factor - α