Detection of Insulitis by Pancreatic Scintigraphy With 99mTc-Labeled IL-2 and MRI in Patients With LADA (Action LADA 10).

Objective Pancreatic Scintigraphy With Interleukin-2 Radiolabeled With 99MTc (99MTc-Il-2) Is A Technique Used To Image Chronic Inflammatory-Mediated Disorders. We Used This Method To Detect A Signal Consistent With The Presence Of Insulitis In Patients With Autoimmune Diabetes. Positive And Negative Controls (Patients With Pancreatic Carcinoma And Type 2 Diabetes, Respectively) Also Were Studied. Research Design And Methods We Examined 25 Patients With Autoimmune Diabetes (16 With Recently Diagnosed Type 1 Diabetes, 9 With Latent Autoimmune Diabetes In Adults [Lada]), 6 With Type 2 Diabetes, And 7 With Pancreatic Carcinoma (The Latter Two Groups Were Used As Negative And Positive Controls, Respectively). All Patients Underwent 99MTc-Il-2 Scintigraphy And Contrast-Enhanced Mri Of The Pancreas. To Validate Positive Controls, Samples Were Taken From Patients With Pancreatic Carcinoma During Surgery For Histological And Immunohistochemical Investigations. Results Pancreatic Accumulation Of 99MTc-Il-2 Was Detected In Patients With Autoimmune Diabetes (61% Positive) And, Notably, In 6 Of 9 Patients With Lada; Semiquantita-Tive Evaluation Of Pancreatic Uptake Of 99MTc-Il-2 Showed Higher Values In Patients With Autoimmune Diabetes (Both Childhood And Lada) And Pancreatic Carcinoma Than In Those With Type 2 Diabetes (4.45 ± 1.99, ± 4.79 1.1, And 4.54 ± 1.62 Vs. 2.81 ± 0.63; P = 0.06, P = 0.01, And P = 0.04, Respectively). In Patients With Pancreatic Carcinoma, Pancreatic Interleukin-2 Receptor Expression Correlated With Pancreatic ±Tc-Il-2 Uptake (R = 0.8; P = 0.01). In Patients With Lada, ±Tc-Il-2 Uptake Inversely Correlated With Duration Of Disease (R = 0.7; P = 0.03). Conclusions Autoimmune Diabetes In Adults Is Associated With Increased Pancreatic ±Tc-Il-2 Uptake, Indicating The Presence Of Insulitis, Particularly Within 1 Year Of The Beginning Of Insulin Therapy, Similar To Type 1 Diabetes At Diagnosis. [ABSTRACT FROM AUTHOR]