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Hummel, M.* ; Durinovic-Bellò, I.* ; Bonifacio, E.* ; Lampasona, V.* ; Endl, J.* ; Fessele, S.* ; Then Bergh, F.* ; Trenkwalder, C.* ; Standl, E.* ; Ziegler, A.-G.*

Humoral and cellular immune parameters before and during immunosuppressive therapy of a patient with stiff-man syndrome and insulin dependent diabetes mellitus.

J. Neurol. Neurosurg. Psychiatr. 65, 204-208 (1998)
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OBJECTIVES: Humoral and cellular immune reactivity are reported for two neuroendocrine autoantigens-glutamic acid decarboxylase (GAD) and the protein tyrosine phosphatase IA-2-in a patient with the autoimmune type of stiff-man syndrome and insulin dependent diabetes (IDDM). METHODS: Antibodies and T cell proliferation against GAD and IA-2 and cytokine release of antigen stimulated T cells (IFN-gamma) were determined before and several times during immunosuppressive therapy with prednisolone. RESULTS: Raised GAD antibodies against full length GAD65 or chimeric constructs were detected before therapy and they remained at a high concentration despite a marked clinical improvement during cortisone treatment. Antibodies to IA-2 were undetectable, but weak T cell responses to both GAD and IA-2 were seen before therapy and once on reduction of high cortisone dosages when the patient showed signs of clinical deterioration. Cytokine profiles showed increased IFN-gamma production after stimulation with GAD or IA-2 suggesting increased activation of TH1 cells. CONCLUSION: Immunosuppressive therapy --even with extremely high doses of 500 mg a day--does not lead to the reduction of antibody concentrations in the periphery nor to a switch in epitope recognition of such antibodies despite clinical improvement. The amount of T cell reactivity to various antigens, however, may be a useful marker to monitor the effectiveness of immunotherapy.
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Publication type Article: Journal article
Document type Scientific Article
ISSN (print) / ISBN 0022-3050
e-ISSN 1468-330X
Quellenangaben Volume: 65, Issue: 2, Pages: 204-208 Article Number: , Supplement: ,
Publisher BMJ Publishing Group
Reviewing status Peer reviewed