Are metabolic and immune parameters associated with residual beta cell capacity one year after T1D onset?

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Abstract Summary

Background
The course of beta cell function decline is very heterogenous after T1D onset. We aimed to describe the natural course of residual insulin secretion over the first year after T1D diagnosis and to determine the predictors of the partial remission within metabolic and immune parameters.

Methods
A total of 38 children with new onset T1D (20 girls), aged 9.4 years (SD±4) were prospectively followed-up for 1 year. HbA1c and total daily dose of insulin (TDD) were obtained at baseline, 6 and 12 months. The insulin-adjusted A1c (IDAA1c) and partial remission (IDAA1c≤9) were calculated. A mixed-meal tolerance test was performed at 12 months and area under the curve (AUC) of C-peptide was estimated. All subjects were screened for immune markers (Treg,Th17,Th1,MFI BAFFR CD4,MFI BAFFR CD8,CD19,mDC,pDC) at baseline, 6 and 12 months.

Results
A total of 66% of patients achieved partial remission at 6 months as compared to only 45% at month 12. We observed a linear increase of C-peptide AUC with the age of patients (p<0.0001). The TDD of insulin (p<0.009) and IDAA1c (p=0.02) increased significantly with the decrease of C-peptide AUC regardless of age. HbA1c at 12 months was not associated with C-peptide AUC. Dynamics of immune parameters was reflected in an increase of Tregs (p=0.02) and a significant increase of originally low pDCs (p<0.001). Interestingly, the expression of a receptor for BAFF was markedly increased on B lymphocytes (MFI BAFFR CD19; p<0.001) and to a lesser extent also on T lymphocytes over 12 months period regardless of their C-peptide AUC. Curiously, the number of CD4+ BAFFR (p<0.015) and also CD8+ BAFFR expressing cells (p<0.014) were the only ones positively correlated to C-peptide AUC. The correlation between HbA1c and immune parameters varied at all visits.

Conclusion
These data imply that low HbA1c is not associated with partial remission at 12 months. The exact role of changes immune markers for beta cell function decline remains hypothetical.

Submission ID :
IDS83241
Submission Type
Abstract Topics

Associated Sessions

Charles University in Prague and University Hospital Motol, Department of Pediatrics, Czech Republic
Department of Immunology, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
Department of Immunology, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
Department of Pediatrics, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
Department of Pediatrics, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
Department of Pediatrics, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
Department of Immunology, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
Department of Immunology, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
Charles University in Prague and University Hospital Motol, Department of Pediatrics, Czech Republic

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KEY DATES

Event dates:
Thursday 25 October - Monday 29 October 2018

Abstract submission deadline:
Monday 14 May 2018

Abstract notification:
July 2018

Early registration deadline:
Monday 3 September 2018

Registration deadline:
Monday 15 October 2018

Contact
British Society for Immunology
+44 (0)20 3019 5901
congress@immunology.org