Study of V-Domain Immunoglobulin Inhibitor of T-Cell Activation Marker in Iraqi Patients with Diabetes Mellitus Type-1

Abstract

Type 1 diabetes mellitus (T1DM) is an autoimmune ailment where the immune system destroys the β-cells in the pancreas, ensuing in absolute insulin insufficiency.   Understanding immune regulatory markers may cause new techniques of diagnosis and therapy in addition to a deeper know-how of the mechanisms underlying disorder.   The checkpoint protein VISTA which regulates Tcell activity and immunological tolerance is one example of such a hallmark. To evaluate serum VISTA levels in Iraqi patients with T1DM compared to healthy individuals, and to explore its potential as an immunological biomarker for early detection, risk stratification, and monitoring of the disease. A case-control study including 150 participants 100 T1DM patients and 50 healthy controls was conducted in Baghdad. The levels of C-peptide, VISTA, fasting blood sugar (FBS), and HbA1c in blood samples were measured using ELISA. T1DM patients showed significantly higher HbA1c and FBS levels compared to healthy controls. C-peptide levels were drastically reduced in patients, indicating near-total loss of β-cell function. VISTA levels were markedly elevated in patients (339.78 ng/mL) compared to controls (134.46 ng/mL). Positive correlations were observed between HbA1c and VISTA, as well as FBS and VISTA, suggesting that chronic hyperglycemia may influence immune checkpoint activity. In conclusion, T1DM, VISTA seems to be a promising biomarker that may be used for risk assessment, disease monitoring, and early identification.  Also, VISTA pathway targeting could be a new therapeutic strategy to control immune responses and maintain β-cell function.