In situ characterization of autoimmune phenomena and expression of HLA molecules in the pancreas in diabetic insulitis

N Engl J Med. 1985 Aug 8;313(6):353-60. doi: 10.1056/NEJM198508083130604.


After the death of a 12-year old girl with newly discovered insulin-dependent diabetes mellitus, we used monoclonal antibodies in an effort to identify the cells invading the pancreas. The majority of infiltrating lymphocytes were of the T cytotoxic/suppressor phenotype, but other T-cell subpopulations were present. Some of the T cells were "activated" (positive for HLA-DR antigen, and the interleukin-2 receptor). Immunocytes bearing IgG were scattered in the gland, and complement-fixing IgG antibodies were deposited in some islets. Increased expression of Class I (HLA-A, B, and C) molecules was observed in the affected islet cells, and in damaged islets showing scant lymphocytic infiltration, some beta cells (still producing insulin), but not glucagon or somatostatin cells, were HLA-DR positive. The capillary endothelium was markedly dilated and strongly HLA-DR positive. These findings may contribute to an understanding of the sequence of events leading to the destruction of beta cells in classic Type I diabetes mellitus.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal
  • Antibodies, Viral / analysis
  • Autoimmune Diseases / immunology*
  • B-Lymphocytes / pathology
  • Capillaries / immunology
  • Capillaries / pathology
  • Child
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 1 / microbiology
  • Diabetes Mellitus, Type 1 / pathology
  • Endothelium / immunology
  • Endothelium / pathology
  • Female
  • HLA Antigens / analysis*
  • HLA Antigens / immunology
  • HLA-A Antigens
  • HLA-B Antigens
  • HLA-C Antigens
  • HLA-DR Antigens
  • Histocompatibility Antigens Class II / analysis
  • Humans
  • Immunoglobulin G / analysis
  • Inflammation
  • Islets of Langerhans / immunology*
  • Islets of Langerhans / microbiology
  • Islets of Langerhans / pathology
  • T-Lymphocytes, Cytotoxic / immunology
  • T-Lymphocytes, Regulatory / immunology


  • Antibodies, Monoclonal
  • Antibodies, Viral
  • HLA Antigens
  • HLA-A Antigens
  • HLA-B Antigens
  • HLA-C Antigens
  • HLA-DR Antigens
  • Histocompatibility Antigens Class II
  • Immunoglobulin G