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[Morphologic and functional changers in B-cells and vessels of the islands of Langerhans in patients with insulin-dependent diabetes mellitus].

Pancreatic biopsies from 49 patients with IDDM were studied. Ultrastructurally, a heterogeneity of B-cell morphological changes and microangiopathy of the Langerhans islands were observed. Langerhans islands containing B-cells with destructive changes were found in 27 biopsies, sclerosis and hyalinosis of vascular wall in 6 biopsies. Langerhans islands sclerosis was found in 13 biopsies and in 9 biopsies, in normal structure of the acinar compartment of the pancreas, Langerhans islands were not found. The authors findings and literature data allowed the conclusion on the stage pattern of IDDM development. The basis is an immune, autoimmune mechanism of B-cell and endotheliocyte of the Langerhans islands damage, and therefore, a decrease of the (pro)insulin synthesis and its transport into the circulation. This process is genetically predetermined, this being confirmed by the lack of the dependence of B-cell and vessels damage in the Langerhans islands upon the age and small fluctuations in the manifestations and duration of the disease.