Contemporary ideas about pathophysiological mechanisms of immunity destruction in the preclinical stage of type 1 diabetes


  • Popova V. V. SI «V. P. Komissarenko Institute of Endocrinology and Metabolism of NAMS of Ukraine», Kiev, Ukraine
  • Zak K. P. SI «V. P. Komissarenko Institute of Endocrinology and Metabolism of NAMS of Ukraine», Kiev, Ukraine
  • Tron’ko N. D. SI «V. P. Komissarenko Institute of Endocrinology and Metabolism of NAMS of Ukraine», Kiev, Ukraine



immune system, type 1 diabetes mellitus


The results of own studies on the role of the immune system in mechanisms for development of type 1 diabetes mellitus (T1DM) in humans that have been performed for 20 years in 612 normoglycemic children of Ukraine with a burden heredity which are positive and negative against pancreatic islet autoantibodies (OAA) are summarized in the article according to the program of the IPDM. There were confirmed data that the high titre of two (especially IA-2A and GADA) and more OAA is a reliable biomarker for diagnosing the presence of preclinical asymptomatic stage of T1DM and predicting its appearance in advance (sometimes for years) in still healthy people. The preclinical stage in OAA-positive children is characterized by moderate neutrophilopenia, monocytosis with a change in their ultrastructure, a decrease in the absolute number of CD3 + T, CD4 + T and CD8 + T lymphocytes and CD56 + cells. In the subpopulation of CD4 + T cells, a disorder of the submicroscopic organization of Holl's bodies is noted. At the same time, there is an increase in the level of proinflammatory cytokines IL-1α, IL-1β, IL-6 and TNFα, as well as chemokines IL-8 and IL-10 and simultaneous decrease of immunoregulatory cytokines IL-4 and IL-10. The obtained data indicate that already in the preclinical stage of T1DM immunity is significantly impaired in the body of normoglycemic children, that is consistent with the recently expressed opinion that the T1DM should be diagnosed not only when most of the beta cells have been destroyed, but in the stage of pre-diabetes, when immune intervention preventing the progression of the disease is still possible.


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How to Cite

Popova, V. V., Zak, K. P., & Tron’ko, N. D. (2019). Contemporary ideas about pathophysiological mechanisms of immunity destruction in the preclinical stage of type 1 diabetes. Problems of Endocrine Pathology, 69(3), 136-143.