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The incidence of specific islet cell autoantibodies in patients with HNF1A-MODY and HNF4A-MODY
Urbanová, Jana ; Anděl, Michal (advisor) ; Štechová, Kateřina (referee) ; Bém, Robert (referee)
Islet cell autoantibodies are associated with autoimmune insulitis and belong to the diagnostic criteria of Type 1 diabetes mellitus. However, growing evidence suggests that autoantibodies are present in other types of diabetes. Here, we focus on the autoantibody incidence in Czech patients with maturity-onset diabetes of the young (MODY) and analyze their functional relevance in terms of diabetes onset and control. Autoantibodies against glutamic acid decarboxylase 65 (GADA) and protein tyrosine phosphatase islet antigen 2 (IA-2A) were measured in a cohort of 28 Czech patients with MODY (all confirmed by genetic testing). Selected clinical data were correlated to the status and kinetics of autoantibodies. One quarter of patients with MODY examined (7/28; 25%) was positive for GADA or IA-2A. GADA were more prevalent (7/7) than IA-2A (1/7). The incidence of autoantibodies did not correlate with human leukocyte antigen status, nor with particular mutation in MODY genes. The patients who were positive for the autoantibodies developed diabetes later than those who were autoantibody- negative, but had worse glycaemic control. Expression of autoantibodies decreased with any improvement of diabetes compensation. Only one patient did not correspond to the above and displayed signs of combined signs of MODY...
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The changes in endocrine function and inflammatory profile of adipose tissue and peripheral monocytes of patients with obesity: the influence of physical activity and bariatric surgery
Trachta, Pavel ; Haluzík, Martin (advisor) ; Maruna, Pavel (referee) ; Štechová, Kateřina (referee)
(EN) Research in the field of obesity, diabetes mellitus and their complications in recent years is increasingly focused on pathophysiological mechanisms of their onset and potential prevention and treatment. The aim of the present work was to evaluate the effects of two different interventions - sleeve gastrectomy and physical activity - on anthropometric, biochemical, hormonal parameters and mRNA expression of proinflammatory factors in subcutaneous adipose tissue along with mRNA expression in peripheral blood monocytes in patients who underwent sleeve gastrectomy. A total of 15 obese women with hypertension were included into the physical activity study. These patients underwent a 3-month training program, which included 30 minutes of aerobic exercise three times a week. 13 obese women were included into sleeve gastrectomy study and were followed-up for 2 years after surgery. Our results indicate that in both studies obese groups had at baseline significantly increased mRNA expression of proinflammatory cytokines, adipokines, chemokines and chemokine receptors relative to control groups. Both interventions decreased body weight and low-grade inflammation. Physical activity had no significant effect on blood pressure, lipid profile and mRNA expression of the components of the renin-...
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Immunointerventional therapy of autoimmune diabetes with recent oncet in NOD mice.
Vargová, Lenka ; Saudek, František (advisor) ; Štechová, Kateřina (referee) ; Mráz, Miloš (referee)
Introduction: Type 1 diabetes mellitus is a chronic metabolic disease caused by autoimmune destruction of pancreatic beta cells. The theory of the disease onset is derived from study of a disease course in non-obese diabetic (NOD) mice, in which the diabetes occurs due to a dysregulation of the immune system. Experimental and clinical studies showed that the autoimmunity may be abrogated by immune intervention, which if initiated early enough may at least slow down the ongoing beta cells lost and preserve residual insulin secretion. But immune intervention alone is not sufficient to restore normoglycemia in the majority of cases. Several interventional studies showed that stimulation of proliferation and/or regeneration of beta cells are necessary to restore normoglycemia in animal models. Aim of the study: To find out, if the combination of a potent immunosuppression (murine anti-thymocyte globulin (mATG), gusperimus) together with stimulation of islet regeneration (sitagliptin) will be able to slow down or reverse the course of the disease. Another aim is to identify the mechanism by which the substances act. Material and methods: All experiments were performed in female NODShiLtJ (H2g7 ) mice. The following parameters were examined at day 0, 7, 14 and 28: blood glucose, subpopulations of...
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Immunological markers for type 1 diabetes prediction
Včeláková, Jana ; Štechová, Kateřina (advisor) ; Černá, Marie (referee) ; Kverka, Miloslav (referee)
5 Abstract Type 1 diabetes (T1D) is an organ specific autoimmune disorder characterised by the immune-mediated destruction of insulin-producing pancreatic beta cells. Beta-cell destruction is mediated primarily by cellular components of the immune system, especially auto-reactive T cells. Nowadays, a goal of many studies is built up the best system for identification of individuals in prediabetes stage and to treat them to preserve sufficient amount of insulin producing beta cells. We identified several candidate pathways and proteins which could be important in pathology of T1D, like an antiviral responses and differentiation of Th17 pathways. We observed differences in dendritic cells count and in their cytokines production. Our data support the notion that the establishment of proinflammatory environment in genetically predisposed individuals along with the involvement of non-specific immune mechanisms is critical for the initiation of autoimmune, destructive insulitis. Nonetheless, patient's autoantibody profile reflects the type of cellular immune response and should be take in a count as well. This finding may be useful in design of immunointervention studies to prevent T1D. Considering the heterogeneity of the clinical course of this disease and perhaps different mechanisms of molecular pathology,...
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Cytokine polarisation in immunopathological disorders
Durilová, Marianna ; Štechová, Kateřina (advisor) ; Tučková, Ludmila (referee) ; Slavčev, Antonij (referee)
6 Abstract Cytokines as primary modulators of immune system cells play a key role in their development, maintenance and activity of each cell population. Cytokine profile of peripheral blood mononuclear cells thus reflects the immunopathological events involved in pathogenesis of the disease. Focus of my thesis was cytokine dysbalance in several immunopathological disorders (type 1 diabetes mellitus, autoimmune thyroiditis, allergic colitis) with the aim to find distinctive cytokine profile of each disorder and to point out common features and differences in these disorders. Protein array and enzyme-linked immunosorbent assay (ELISA) method were used for analysis of cytokines in breast milk and cytokines produced in vitro by peripheral and cord blood mononuclear cells spontaneously and after stimulation by autoantigens. First immunological disorder to study was type 1 diabetes mellitus (T1D), where patients with T1D were studied (n = 10) as well as their first degree relatives (n = 9), with particular group of neonates whose one parent suffered from T1D (n = 52). In patients with T1D prediabetic phase was dominated by spontaneous and postimulatory production of Th1- associated cytokines (IFN-γ, TNF-β) which dropped at the time of T1D manifestation and remained suppressed for at least two following years....
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Cord blood T regulatory cells and their association with development of type 1 diabetes
Norková, Jindra ; Štechová, Kateřina (advisor) ; Černý, Jan (referee)
Type 1 Diabetes (T1D) is organ-specific autoimmune disease which causes pancreatic beta cells to be irreversibly destroyed. The only possible treatment represents life-lasting insulin administration. The real trigger of destructive insulitis isn't known. T1D is a multi- factorial disease involving both external and internal factors in the disease pathogenesis. The presence of autoreactive T lymphocytes in pancreas is necessary for development of diabetes. T regulatory cells have protective function in the destructive insulitis. The aim of this diploma thesis was to study cord blood T regulatory cells and their connection to type 1 diabetes development. We tried to find the difference among T regulatory cells in mononuclear cord blood cells (CBMC) in different study groups. Samples were collected from mothers suffering from T1D, gestational diabetes. Healthy controls were tested as well. Sixty-eight samples of cord blood were included in the study among the years 2009 - 2011. Samples were divided into 3 groups (CBMC from children born to T1D mothers, mothers with gestational diabetes and healthy mothers without T1D). CBMC were ana- lysed by flow cytometry. T regulatory cells (defined as CD4+CD25+) were isolated by magnetic separation (MACS). The functional capacity of these cells was studied as well by...
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Differentiation of adult stem cells into insulin-producing beta cells
Koblas, Tomáš ; Saudek, František (advisor) ; Grim, Miloš (referee) ; Štechová, Kateřina (referee)
Ph.D. Thesis abstract: Diabetes mellitus is a chronic disease characterized by a metabolic disorder in which there is a low level or complete lack of the insulin. Diabetes mellitus type 1 (DM1) is caused by an autoimmune reaction leading to the destruction of the insulin producing beta cells in the pancreas. In consequence, low or non-existent insulin production leads to a complete dependence on exogenous insulin supplementation. DM1 causes serious long-term complications. Although strict control of blood sugar could prevent the onset and development of diabetic complications only 5% of diabetic patients are able to achieve such control. Hence it is evident that the current methods of treatment are neither sufficient to treat this disease, nor prevent late complications in most patients. The most promising therapeutic approach in the treatment of diabetes is the restoring of insulin production. One such method is the transplantation of insulin-producing tissue. However, a lack of available insulin- producing tissue limits such therapeutic approach. Therefore an alternative source of insulin producing cells have to be found to obtain a sufficient amount of safe and efficient insulin producing tissue. Pancreatic stem/progenitor cells could represent such an available alternative source. Despite the evidence...
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Effect of diabetogenic autoantigens on the cytokine production of peripheral blood mononuclear cells from type 1 diabetic patients
Labiková, Jana ; Štechová, Kateřina (advisor) ; Holáň, Vladimír (referee)
5 Abstract Type 1 diabetes (T1D) is a serious organ-specific autoimmune disease characterised by irreversible destruction of pancreatic β-cells by immune system. This process results in an absolute insulin deficiency. Both genetical predisposition and environmental factors influence the development of the disease. β-cell destruction is mediated by cellular components of an immune system. Proinflammatory Th1 response is considered as most pathological. Autoimmune destruction of β-cells can be identified by the detection of specific serum autoantibodies a long time before the T1D clinical onset. Currently, there is no efficient cure available to prevent or at least to delay the destructive insulitis. This diploma thesis describes the influence of synthetic diabetogenic autoantigens GAD65 and IA2 on the cytokine response of peripheral blood mononuclear cells (PBMC) obtained from T1D patients with regards to their antibody profile. The study has been carried out on patients with confirmed T1D diagnosis who tested positive for anti-GAD65 and/or anti-IA2 autoantibodies. By using flow cytometry we measured the cell type ratio in PBMC samples. The cells have been stimulated by three different concentrations of antigens and their IFNγ and IL-17 production has been detected by ELISPOT assay. In the case of both...
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Dendritic cells and autoimmune diseases with a view to type 1 diabetes mellitus
Chrástová, Iveta ; Štechová, Kateřina (advisor) ; Krulová, Magdaléna (referee)
Dendritic cells (DC) are professional antigen-presenting cells (APC) that play an essential role in the induction of immune responses. DCs develop from CD34+ hematopoietic stem cells in bone marrow and their role is uptake, processing and presentation of antigens to T cells. DCs can be divided into two distinct subset of cells, myeloid a plasmacytoid DCs. Myeloid DCs (mDC) develop from hematopoietic cells in the presence of GM-CSF and TNF-α or from monocytes in the culture with GM-CSF and IL-4, then with CD40L they mature and produce a large number of IL-12, which is important in driving CD4+ T cell to type Th1. The development of pDC is CD40L and IL-3 dependent and Flt3-L supports this process as well. The essential role of pDC is that they secrete a large amounts of type I IFN in the responses to viruses and so they maintain the antiviral stage. To recognize the viruses pDC express Toll-like receptors 7/9. DCs have on the surface also other groups of receptors, e.g. C-type lectin-like receptors, RIG-I-like receptors and NOD-like receptors. They play the role in the various diseases, mostly autoimmune diseases, in which the immune system recognizes self tissues and activates against them the immune response. Dendritic cells function is that they are competent to activate T cells, in the most cases...
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