Diabetes Immune Mechanism

Question 1

Obesity

Effects Leading to Diabetes

Answer 1

Increased LCFFAs and MCFFAs
Cause increased M1 Macrophages
Release TNFalpha, IL-1, IL-6, IFN-gamma and increase NO
Cause increased Th1, CTLs and Neutrophils

Question 2

Lean Body Diabetes Protective Factors

Answer 2

Increased SCFFAs, M2 Macrophages, IL10, Th2, Treg and Eosinophils

Question 3

Type 2 Diabetes Risk Factors

Answer 3

Genetics: 52 high risk alleles, 40% risk if one parent, 70% risk if both parents have them

Environmental: Pesticides, Herbicides and Diesel Car Pollution

Behavioral: Sedentary lifestyle and high fat diet

Question 4

Type 1 Diabetes Risk Factors

Environmental, Microbiota and Behavioral

Answer 4

Enteroviruses, Mumps, Rubella

Low butyrate-producing microbiota

Early cereal, root vegetable, egg and cow’s milk diet

Question 5

Type 1 diabetes Protective Factors

Answer 5

Breast milk feeding increases insulin immune tolerance

Omega 3 FAs protective

Class 3 VNTR increases insulin

Question 6

Type 1 Diabetes Genetic Risk Factors

Answer 6

HLA - DQ2/DQ8 seen in most T1D Pts
HLA - DR3/DR4 increases risk in children

CTLA4 Defect - decreased auto T cell suppression

AIRE Defect - decreases central tolerance (-) selection

Class 1 VNTR - decreases insulin mRNA and central tolerance

Question 7

Islet Cell Auto Antibodies

Types and Use

Answer 7

GAD65, IA-2, IAA

Used for early Type 1 Diabetes diagnosis

Question 8

Type 1 Diabetes Microflora Issues

Answer 8

Decreased Bacteriodetes and Firmicutes

Decreases Treg cells and causes defective FOXP3

Question 9

Type 1 Diabetes Immunopathogenesis

Answer 9

IFN-gamma decreases Th2 and causes Beta cell Ag presentation
Dysregulated T cells activated and produce IFN-gamma, IL-1, TNF-alpha
M1 Macrophages increased