Cytokine detection by ELISPOT: relevance for immunological studies in type 1 diabetes.

Diabetes mellitus type 1 is a chronic disease in which the insulin-secreting ss-cells are selectively destroyed by an immune-mediated process. Autoantibodies directed against several islet antigens are useful parameters to estimate the risk to develop diabetes, but cell-mediated immunity involving T lymphocytes plays a major part in causing the specific destruction of ss-cells. T cells are characterized by their antigen-specificity, phenotype and cytokine-secreting profile. T cells that secrete cytokines of the T helper 1 (Th1) type have been shown to transfer diabetes in animal studies, in contrast to T helper 2 (Th2) cytokine-secreting T cells that are thought to be rather nondestructive. In the absence of phenotypic markers for Th1 and Th2 cells, several different approaches have been taken to examine T cell responses in detail. Methods involve T-cell proliferation assays, Enzyme-Linked-Immuno-Sorbent-Assay (ELISA) analysis of secreted cytokines and phenotype analysis applying flow cytometry. A more recent development is ELISPOT analysis, which enables the investigator to determine the qualitative and quantitative antigen-specific immune response on a single-cell level with regard to cytokine secretion. This article aims to give an introduction to the advantages and limitations inherent in the different techniques and their potential relevance for immunological studies in diabetes mellitus type 1. Copyright 2002 John Wiley & Sons, Ltd.